Method of nail plate deformation prevention in paronychia treatment

IPC classes for russian patent Method of nail plate deformation prevention in paronychia treatment (RU 2395240):

A61P41 - Drugs used in surgical methods, e.g. surgery adjuvants for preventing adhesion or for vitreum substitution

A61K31/498 -

A61B17 - Surgery

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FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to ambulatory surgery and can be used for treatment of nail panaritium. For this purpose from the side of affection made is zigzag cut on the whole height of nail plate in zone of lateral ridge up to unaffected growth zone of nail plate. After sanitisation applied are gauze bandages, soaked with dioxydin solution, which are replaced two times a day till wound purification.

EFFECT: method ensures prevention of formation of rough nail plate growth, prevention of quick plate growth and complications in inflammation focus, quick purification of operation wounds and stopping of inflammatory process in affected finger.

1 ex, 1 dwg

The invention relates to medicine, namely to ambulatory surgery, and for the prevention of the formation of rough growth of the nail plate and nail treatment felon.

There is a method of treatment of paronychia, which produce linear incisions in the area of the inflamed nail fold of the affected finger, bandaging wounds (Myitkina. Whitlow., Honey, 1975, p.60).

There is a method of treatment of paronychia, which produce a pair of linear incisions in the field edges and inflammation of the nail fold, necrectomy and bandaging wounds (Waapu and other Felon. - L.: Honey. 1986, s, p.137).

There is a method of treatment of nail felon, which is that an incision in the field of inflammatory lesion of the nail fold, necrectomy, the introduction of drugs (antibiotics) into the base of the affected finger and bandaging wounds (Whitrock and other Antibiotics in surgery, 1973, s).

The disadvantages of the above-described analogs that linear incisions at these ways to treat paronychia irrational, since the edges of linear wounds after surgery quickly closed, poorly drained or regenerate up of inflammation in the lesion, which leads to complications in the form of re-purulent inflammation of lower fabrics ungual phalanx.

The prototype izopet the Deposit is a method of treatment of purulent felon, namely, that excision of necrotic tissue of the nail fold to produce a wedge-shaped slit in the base of the affected finger administered antibiotics (penicillin or streptomycin, depending on the sensitivity of the patient to the drug, the dose 1000000 500000 units respectively in 7-10 ml of 0.25-0.5% solution of novocaine), followed by drainage of the wound using a vacuum pump connected to worn on the finger sealing tip, which is used as the body of a disposable system for intravenous fluids (Patent RU 2062607, 1996.).

A significant drawback of this method is that the authors have conducted bilateral wedge cuts, this causes the nail plate to deformation of its surface and in its expansion of the fast scheduling in the bed of the nail angle due to its rapid growth, re-inflammatory process, re-excision of the plate.

In addition, the use of vacuum suction irrational in this case, the treatment due to the fact that is forced drainage, which leads to disruption of natural, spontaneous discharge of exudate, and vacuum compression of surrounding tissues, blood vessels, and that entails a violation of the trophic tissue and its long-term regeneration. The use of fingertip also Nar who violates trophism, compresses surrounding tissue, and its tightness adversely affects the enrichment and the contact of the wound with oxygen due to the tight closure of the entire surface of the finger, the fingertip, resulting in oxygen deficiency wounds, trauma to the wound surface due to the force of the vacuum suction exudate on the wound, which leads to the duration of wound healing, lack of regenerating and anti-inflammatory effect.

The technical result is to prevent formation of rough growth of the nail plate, warning of rapid growth plate and complications in inflammatory lesion, rapid purification of surgical wounds and mild inflammation in the affected finger.

The proposed method is as follows. Spend processing the surgical field alcoholic solution, conduction anesthesia by Oberst-Lukashevich. Determine the vastness of the destruction of the nail phalanx. Then spend with the defeat of zigzag incision along the entire height of the nail plate in the area of the side of the roller to the unaffected germinative zone of the nail plate. This provides a slow unprogrammed growth of the nail plate, prevents its rough growth, the scheduling in the nail bed and full discharge of exudate. After VSC is itia ulcer spend reorganization without drainage. Then impose gauze bandage, impregnated with an antibacterial solution Dioxidine. Ligation is carried out 2 times a day to cleanse the wound.

The object of our study was 63 people. 43 patients of the main group were treated with the application of the proposed method.

20 patients formed the control group, which carried out the treatment method of the prototype.

When comparing clinical outcomes in the main and control groups showed the following results.

Based on the results of applying the proposed method in the study group revealed a high regenerative properties, minimal trauma to the tissues of the finger due to the zigzag overlay cut to the nail plate and the slow growth due to the lack of compression and the natural discharge of exudate for the impact on the wound of the medicine and contact the wound from the external environment enriched with oxygen. Also noted where the growth of the nail plate and newtoniana it in the nail bed side roller finger that warned recurrence of inflammation.

Studies show that the application of the proposed method prevents the formation of coarse growth of the nail plate and its rapid growth, the scheduling in the nail bed, provides a full discharge is of csdata, quick cleansing wounds and mild inflammation in the affected finger and prevents complications in inflammatory lesion.

The difference of healing in the main and control groups was 6 days, which indicates the feasibility of applying the proposed method for the rapid rehabilitation and rehabilitation

The invention is illustrated in the drawing, which shows schematically the proposed method.

Clinical example. Patient W., 37 years old (case history No. 3597-08), entered outpatient treatment in the clinic at the station Ufa Ufa, Russian Railways clinic surgical diseases with the diagnosis felon nail phalanx of the thumb.

The treatment by the proposed method. Spent processing the surgical field alcoholic solution, conduction anesthesia by Oberst-Lukashevich. Identified the vastness of the destruction of the nail phalanx. Then ran from the defeat of zigzag incisions the size of a hand up to 0.3-0.5 mm over the entire height of the nail plate in the area of the side of the roller to the unaffected germinative zone of the nail plate. After opening the abscess spent reorganization without drainage. Then put a gauze bandage soaked in antibiotic solution Dioxidine. Ligation was performed 2 times a day. The healing period was 7 days.

Proposed the first method was used in 43 patients with panaritiums thumbs lower and upper limbs. In all cases it has proved to be effective.

The method of treatment of nail felon, including excision of necrotic tissue of the nail fold, antibiotic therapy, characterized in that conduct with the defeat of zigzag incision along the entire height of the nail plate in the area of the side of the roller to the unaffected germinative zone of the nail plate, after rehabilitation impose gauze bandage, impregnated with a solution dioksidina, which are changed 2 times a day to cleanse the wound.