Method of treating subcutaneous hematoma formed by animal bite

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery, and can be used at treating a subcutaneous hematoma formed by animal bite. That is ensured by antiseptic skin preparation, and surgical treatment of a wound if any. Then the hematoma is removed and measured through a puncture or a surgical incision. Thereafter, Perftoran is introduced in skin at 0.01-0.1 ml per 1 cm3 of the measured hematoma. Length of treatment makes three-seven days.

EFFECT: method provides higher quality of treatment of injured soft tissues and lower complications rate due to reduced oedema and improved tissue supply in a lesion ensured by the introduction of Perftoran.

2 ex

 

The invention relates to medicine, namely to surgery, and is intended for treatment of subcutaneous hematoma formed due to animal bites.

With a sharp bite of a mammal, particularly powerful jaws, damage may occur without violating the integrity of the skin, but with bruises and razmozjenie soft tissue with hemorrhage and edema in them, and in the presence of bite wounds around her. It is noticed that the bitten wound may include signs, typical ragged, bruised and crushed wounds and often infected with pathogenic microflora contained in the saliva bite [Kollontai YOU, Panchenko, M.K., Andreson M.V. Open injuries of the hand. Kiev, "Health". 1983. - P.88]. Consider typical for bite wounds ruptured superficial tissues [Weinstein VG Guide traumatology. - L.: Medicine. 1979. - P.71. Postyshev VK General surgery: Textbook.- M: Medicine. 1993. - S]. Injuries are accompanied by objective symptoms: swelling caused by soaking the soft tissues of the streamed blood and lymph; inflammatory edema; sometimes redness and local temperature rise due to the expansion of blood vessels after a brief spasm reflex [Novozhilov D.A. Smirnov, N.V. IN kN.: "Multi-volume manual of Orthopaedics and traumatology". Volume 3. M. Medicine, 1968. C. 11-12]. Occur in damaged from the bite of tissues and subcutaneous hematoma, which can become infected in terms of bacterial contamination. Growing in the damaged tissues oedema with compression of the blood vessels, nerves sometimes, accompanied by malnutrition tissue, inflammation and other pathological phenomena with morphological changes. The conventional treatment of patients with bites mammals focused mainly on surgical treatment of wounds and the prevention of infectious complications. The treatment of soft-tissue damage around the bite wounds, and in the absence of wounds treatment of bruises, short squeeze and crush zone of soft tissues, subcutaneous hemorrhages, is not always given due attention, which prompted us to develop a treatment for patients with subcutaneous hematoma, formed as a result of animal bites.

There is a method of treatment for the bite caused mammal, including copious lavage bite wounds with soap and water, the treatment of the wound with 70% ethanol, and with extensive wound - overlay leading seams [instructions MZ the Russian Federation "On the procedure of work of medical institutions and centres for state sanitary and epidemiological surveillance for the prevention of human cases of rabies", approved by Order of RF Ministry of health No. 297. October 7, 1997, the who and].

The disadvantage of this method can be considered as the treatment of the wound with 70% ethanol, causing a sharp local pain and irritation of the tissues with the appropriate reaction. In this way, there are no actions aimed at improving the quality of treatment with subcutaneous hematoma, formed as a result of animal bites, and reducing the frequency of complications by reducing edema and improving the nutrition of tissue in the lesion.

There is a method of treating soft tissue injuries and bruises, including cold on the place of injury, elevation of the affected part of the body, a pressure bandage, rest, immobilization of the injured limb, with 2-3-day heat treatments, massage, physical therapy, and at large hematomas puncture with aspiration of blood [Bamaw. Surgical care in outpatient clinics. State publishing house of medical literature. M. 1963. S].

The disadvantage of this method is the lack of signs of improving quality of care in the subcutaneous hematoma formed due to animal bites, and reducing the frequency of complications by reducing edema and improving the nutrition of tissue in the lesion.

There is a method of treatment of wounds by subcutaneous parvularia introduction of perftoran in a volume of 10 ml (Loskutov HE Optimization of conditions for the healing of open fractures with parav larnage subcutaneous injection of perftoran. Abstract of thesis. CMN, Kemerovo, 2004, p.6-7).

The disadvantage of this method lies in the subcutaneous introduction of perftoran, which leads to accelerated resorption of funds and reduced the time of his local actions, in contrast to the intradermal injection of the drug in the proposed method with a more prolonged effect on damaged tissue. The disadvantage of the opposed way is also no signs of improving quality of care by reducing edema and improving the nutrition of the tissues around the subcutaneous hematoma, formed as a result of animal bites, and reducing the frequency of complications in it.

There is a method of treatment of wounds by subcutaneous parvularia introduction of perftoran within three to seven days, according to the patent of Russian Federation №2270004.

The disadvantage of this method lies in the subcutaneous introduction of perftoran, which leads to accelerated resorption of funds and reduced the time of his local actions, in contrast to the intradermal injection of the drug in the proposed method with a more prolonged effect on damaged tissue. The disadvantage of the opposed way is also no signs of improving quality of care by reducing edema and improving the nutrition of the tissues around the subcutaneous hematoma, formed as a result of animal bites, and reduce cha is toty complications.

There is a method of treatment for injuries from animal bites ["Managing bites from humans and other mammals. DTB 2004 42(9). Page 67-70], including the introduction of antibacterial drug, the choice of which is based on the data of bacteriological research. Before receiving his results, the drug of choice is amoxicillin/clavulanate (625 mg 3 times a day for adults). If you are allergic to penicillins may prescription metronidazole in combination with doxycycline for bites of dogs and cats. When it bites a person also can metronidazole be used in combination with erythromycin, but preferred is the use of ciprofloxacin in combination with clindamycin. The heavy nature of the infection, antibiotics are administered intravenously, the duration of therapy depends on clinical dynamics.

The disadvantage of this method of treatment for injuries from animal bites is the lack of signs of improving quality of care in the subcutaneous hematoma formed due to animal bites, and reducing the frequency of complications by reducing edema and improving the nutrition of tissue in the lesion.

The closest in technical essence and the achieved result is a method that is listed last, which we take as a prototype, and the drawbacks set forth above.

The technical result of the invention for luchetta in improving the quality of treatment with subcutaneous hematoma, generated as a result of animal bites, and reducing the frequency of complications by reducing edema and improving the nutrition of tissue in the lesion.

The technical result of the invention is achieved by a method for the treatment of subcutaneous hematoma formed due to animal bites, includes antiseptic skin preparation and surgical treatment in the presence of wounds. Moreover, the hematoma is first removed through the puncture or surgical incision with the determination of its volume, then the skin type perftoran the rate of 0.01-0.1 ml of 1 cm3the extracted volume of hematoma treatment within three to seven days.

The essence of the technical solutions is reflected in the specific examples of the method.

A specific example of the method. The man received a bite from a dog. For medical assistance with bitten ragged wound on the back surface of the left tibia with portions of the crush zone at the edges on the square 36 cm2and subcutaneous hematoma in the soft tissues of the damaged area. After using the toilet skin around the wound and wash it produced primary debridement with removal of blood clot without suturing. In the skin distal to the source of damage daily enter the perftoran in 7 ml for four days. Swelling decreased, signs of infection in the wound was not. In subsequent imposed in oricine seams. Healing without necrosis and other complications.

A second specific example of the method. Man three days ago I received from a horse bite left shoulder. Violations of the integrity of the skin there. The skin bruise with fluctuosa underneath the liquid. Estimated hematoma does not pulsate. After antiseptic treatment of skin and analgesia produced a thick hollow puncture needle was withdrawn about 100 cm3bloody fluid. Leather slept, fluctuation disappeared, the allocation of bloody fluid from the needle stopped, the needle is extracted. In intact skin distal to the source of damage is injected perftoran 10 ml for three days. Swelling decreased, signs of infection in the wound was not. Recovery without complications.

The significance of differences between the invented method is as follows.

Introduction distal to the damaged tissues in intact skin emulsion of perftoran in a dose of 0.1-0.2 ml per 1 cm2the surface areas of damage within three to seven days due to the fact that the perftoran - perfluorocarbon emulsion, improves tissue respiration and circulation, reduces swelling of the cells and perivascular edema vessels [Greceanu and others In kN.: "Performancesee compounds in biology and medicine". Pushchino. 1999. S]. Perftoran consider anti-ischemic drug. Incorporating structure of cell membranes, perftoran stabilizes the endothelium of blood vessels and cell membranes (Whichmakes and others In kN.: "Performancesee compounds in biology and medicine". Pushchino. 1999. S-145]. Eliminating the spasm of blood vessels, it restores microcirculation, reduces swelling of the endothelium of blood vessels, restores tissue gas exchange and metabolism (VMS, Nilow. In the book: "Performancesee compounds in biology and medicine". Pushchino. 1999. P.26-30]. Perftoran increases the viability of the tissues indirectly through normalization of microcirculation and metabolic processes in the cells. The introduction of perftoran reduces the severity of toxemia and has a favorable effect on the rheological properties of blood [Gastronom et al., 2001; RAO et al. Saint-Petersburg. 2001. P.21]. Perftoran reduces the amount of peroxide oxidation in the tissues, which leads to the resolution of vasospasm, the weakening of microcirculatory disorders and ischemic tissue [Haushalten and others In kN.: "Performancesee compounds in biology and medicine". Pushchino. 1999. P.67]. Therefore, a beneficial effect of perftoran on damaged tissue in the claimed method is caused, mainly, it lipoic, antiexudative analternative and detoxification effect. According to the claimed method summary of perftoran to hurt or crushed in the UCF is and tissues improves tissue respiration and circulation in damaged from the bite of tissue, relieve spasm of the vessels, weakening development of ischemic edema, reduction plasmopara and secondary circulatory hypoxia of tissues, improved metabolism and stabilization of the vascular endothelium and cell membranes, which reduces the severity of swelling and accelerate healing of the wound and restoration of damaged tissues. After removal of the subcutaneous hematoma through a puncture or surgical incision, in the presence of the injured tissue and the lack of extensive razmozjenie can without sacrificing efficiency to reduce the dose of perftoran to 0.01-0.1 ml of 1 cm3volume remote hematoma.

The invented method extends the choice of treatment of patients with subcutaneous hematoma, resulting from the bite caused mammal, reduces swelling and improves tissue nutrition in the lesion, which increases the quality of treatment, reduces the frequency of complications, shortens the treatment of patients and creates economic effect.

The application of the invention it is possible in traumatology, military field surgery, pediatric surgery, as well as in veterinary medicine.

A method of treating subcutaneous hematoma formed due to animal bites, including antiseptic skin preparation and surgical treatment in the presence of a wound, characterized in that the hematoma is first removed through the puncture or surgical incision is the determination of its amount, then in the skin of the injected perftoran the rate of 0.01-0.1 ml of 1 cm3the extracted volume of hematoma treatment within three to seven days.



 

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