Method of treating infected wounds of anterior abdominal wall

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely purulent surgery, and may be used for treating infected wounds. That is ensured by surgical treatment of suppurative focuses and exsection of necrotised tissues. Then the whole wound surface is treated with 10% colloidal nanosilver. The subcutaneous fat is infiltrated with 10% colloidal nanosilver at 0.1 ml of the solution per 1 cm2 of the wound. Additionally, the wound is covered with a sterile 10% colloidal nanosilver wipe.

EFFECT: method enables reducing the length of wound granulation and epithelisation ensured by using the biologically active colloidal nanosilver solution coating all wound layers and rendering selective action on pathogens only.

1 ex

 

The invention relates to medicine, namely to General surgery.

Despite the rapid development of modern medicine and the use of a wide class of antiseptics for the treatment of wounds, the problem does not cease to be relevant because the issues of effective influence on the course of the wound process are solved not always successful [Postyshev VK, omelyanovski CENTURIES the ways and possibilities of prevention of infectious complications in surgery /Surgery. - 1997. No. 8. - Page 11-15]. Currently used for local treatment of purulent wounds antiseptic and antibacterial agents are often ineffective or inefficient, often have side effects that cause immunosuppression [Blind NI Postoperative wound infection: causes and consequences. // Kazan medical journal. - 2001. No. 3. - S].

Known methods of treatment of purulent wounds by washing them with solutions of various antiseptics (U.S. Pat. RF 2068263), antibiotics (U.S. Pat. RF 2008917), by surgical treatment of the wound and applying to areas with necrotic tissue powdered pepsin, (U.S. Pat. RF 2131255), preparations containing proteolytic enzymes (U.S. Pat. RF 2036658). There is a method of treatment of purulent wounds by surgical treatment and subsequent wrapping with drugs (U.S. Pat. RF 2185781). On p is pout phase of wound healing before and after surgery on the wound impose multilayer bandage, the first layer which is impregnated with a proteolytic enzyme, dissolved in 30%aqueous solution of urea, the second layer is a multi-component water-soluble ointment base, which have antibacterial and anti-dehydrating properties, the third layer hydrophobizing naphthalan ointment, and in the second phase provide free skin plastic or impose secondary seams with irrigation drainage in the residual cavity.

A common drawback of all these methods is the low efficiency of the extensive treatment of purulent diseases of soft tissues (30%), the duration of epithelization of the wound (9-12 hours), and complete epithelialization only 30-40 day.

There is a method of treatment of purulent wounds with silver (U.S. Pat. RF 2063232-prototype). The method is the fact that the plate applicator silver model in the form of a wound surface, calcined in an open flame and put directly on the wound surface. After annealing the applicator placed on the ulcer 3-5 days, then the affected surface is placed in gnotobiology insulator for 1-2 days. If necessary, this alternation to produce full recovery.

The disadvantages of this method include:

1. the complexity of the procedure is the necessity of using a special plate of the applicator of silver and so is kalevantie it on an open fire

2. the method is not designed for use at large wound surfaces (>10 cm2full epithelialization of the wound with observed only after 3-4 weeks

There is a method of treatment of purulent wounds with silver (U.S. Pat. RF 2163494), lies in the rehabilitation of a 5% aqueous solution of powergra with the addition of 1% hydrogen peroxide solution in a ratio of 10:1, which is filled rehabilitated cavity immersed waveguide and subjected to ultrasonic treatment, while conducting a flow-wash drainage.

The disadvantage of the method:

1. You add peroxide to enhance the antiseptic effects of powergra, which cannot be achieved by applying them separately.

2. Need additional exposure to ultrasound and the use of flow-irrigation and drainage, which complicates the technique of the method. Flow-washing draining cannot be implemented on the open wounds of soft tissues.

3. Cleansing wounds is provided by rehabilitation peroxide and exposure to ultrasound.

Solved in the invention the task is to develop a method of treatment of purulent wounds of the anterior abdominal wall.

The technical result that is achievable with the use of the method is to reduce the time of granulation and epithelization of the wound, due to the use of biologically AK is positive colloidal solution of nano-silver on all layers of the wound, not calling local worsening immunodeficiency due to the selective action only on pathogenic microorganisms.

The method is as follows.

Perform surgical treatment of purulent foci with excision of necrotic tissue, processing the entire surface of the wound with a 10% solution of colloidal nano-silver. To act on all layers of the wound is investirovanie subcutaneous fat tissue 10% R-m colloidal nano-silver at a rate of 0.1 ml on 1 cm2the wounds.

After using the toilet wounds, sterile cloth moistened with a 10% solution of colloidal nano-silver and leave for the day.

After cleansing the wound impose secondary stitches on the wound.

Clinical example. A patient, 32 years old, he enrolled in the Institute of JV with a diagnosis of Penetrating stab wound of the anterior abdominal wall. In an emergency procedure performed surgery: Laparotomy. Revision of the abdominal cavity, suturing wounds of the small intestine, nasointestinal intubation, sanitation, drainage of the abdominal cavity.

On the 4th day after the operation marked purulent discharge from the lower third of the p/o wounds. With wounds removed 4 suture, the wound treated with a 10% solution of colloidal nano-silver, subcutaneous fat investirovanie 10% R-m colloidal nano-silver at a rate of 0.1 ml on 1 cm2the wounds. In the wound installed sterile is alfetta soaked in 10% p-d colloidal nano-silver. After 1 day after application of the solution: the wound is completely free of purulent discharge. 2 days - marked granulation and epithelialization of the wound. Superimposed secondary seams. Complete epithelialization of wounds noted on 6 days. The wound healed by secondary intention, the sutures were removed on the 14th day, the patient in a satisfactory condition was discharged from the hospital.

As a colloidal solution of nano-silver, it is advisable to use the drug "Agbion-2" (patent No. 2341291). Agbion is a highly effective antibacterial agent based on the fine silver particles in aqueous solution. Thus the solution has a high biological activity against microorganisms and stores it in a long time. Microbiological activity in solution Agbion are not silver ions and not his uniform uncharged particle size of about 3-4 nm, and polydisperse system, consisting of a set of particles with a size distribution with its main part in the range of 5-16 nm. Biological activity against all microorganisms (taken in doses of 106, 102, 104), provides versatility of the drug.

The method of treatment of purulent wounds, including surgical treatment of purulent foci with excision of necrotic tissue and subsequent dressing, characterized in that after excision of n is cruiseaway tissues treat the entire surface of the wound 10%solution of colloidal nano-silver, infiltrate the subcutaneous fat 10%solution of colloidal nano-silver at a rate of 0.1 ml on 1 cm2the wound and the wound impose on the day a sterile cloth moistened with a 10%solution of colloidal nano-silver.



 

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2 ex

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2 ex

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2 ex

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