Method of treating trophic ulcers and infected persisted wounds

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery, and may be used in treating trophic ulcers and infected persistent wounds. That is ensured by the exposure to an argon plasma flow in a dose of 100-250 J/cm2 at 10-25 cm from the treated surface. The exposure length on one field makes 10-25 seconds. The sound surface treatment is followed by the dynamic exposure to a running argon plasma flow at 10-20 cm in a dose of 80-150 J/cm2 over the whole wound surface to form a gloss on the wound surface.

EFFECT: method provides the effective treatment of the given pathology ensured by specifying a mode of the exposure causing the microorganism elimination, wound surface drying, sudden perifocal oedema reduction, as well as epithelial cell growth stimulation on the periphery of the wound, as well as on its free surface.

3 ex

 

The invention relates to medicine, in particular to surgery, and can be used in the treatment of trophic ulcers and infected nonhealing wounds.

Currently, there are many ways the treatment of venous ulcers and infected nonhealing wounds, ranging from pharmacological preparations (acerbis, prostasin, various ointments) and ending with the impact on biological tissue of various kinds of energies (helium-neon, and carbon dioxide lasers, laser installation, ultrasonic radiation, electro and cryocoagulation). Despite the abundance of methods of treatment of these pathologies, the problem of the treatment of trophic ulcers and infected nonhealing wounds is still relevant, because all the available treatments do not affect the entire healing process, or are preparatory phase autodermoplastiki not always successful.

There is a method of treatment of venous ulcers (U.S. Pat. Of the Russian Federation No. 2198702, CL A61N 5/067, publ. 20.02.2003 year). The method is non-contact surface treatment of trophic ulcers after how agressively to debride and is used only as a stage of preparation sores to autodermoplasty.

There is a method of treatment of trophic ulcers and nonhealing wounds (U.S. Pat. Of the Russian Federation No. 2164426, CL A61N 5/067, A61K 33/34, publ. 27.03.2001 year). The method consists of exposure of Infrakrasnye to put on the trophic ulcer napkin from dialdehydes with the subsequent application of an antioxidant of plant origin "Tykveol" and aytodermoplastics.

The disadvantage of this method is that it is a preparatory stage of autodermoplastiki and as a way of self-healing of trophic ulcers and nonhealing wounds are irrelevant.

There is a method of treatment of trophic ulcers of venous etiology (U.S. Pat. Of the Russian Federation No. 2357772, CL A61N 5/067, A61K 31/409, A61K 33/08, A61P 17/02, publ. 10.06.2009,). How is that on the surface of the ulcers and the skin around the ulcer is treated with air-gas stream containing nitric oxide is not less than 2000 ppm at a temperature of 40° exposure 10 seconds on 1 cm2. Then as a photosensitizer is applied 0.1% gel Radachlorin dose of 0.2 g per 1 cm exposure time of 60 minutes. Then carry out the action of the laser light wavelength 0,665 μm at a dose of light energy of 150-200 j/cm2at a distance of 3-5 mm to the wound surface.

Then spend intravenous irradiation of blood through the cubital vein laser light wavelength 0,632 microns at a radiation power of 5 mW exposure 15 minutes. The course of treatment is 10 daily procedures for handling air-gas stream and intravenous laser irradiation of blood, 5-8 treatments of photodynamic therapy with an interval of 2 days.

The disadvantage of this method is that as an integral component of conducting intravenous irradiation of blood through the cubital menulateral light, may lead to air embolism, different types of thrombophlebitis and phlebothrombosis.

Closest to the claimed technical essence and the achieved result, selected as a prototype, is a method of treatment of trophic ulcers and nonhealing wounds (U.S. Pat. Of the Russian Federation No. 2231377, CL A61N 5/067, A61N 2/06, A61L 15/22, publ. 27.06.2004,).

The method consists in the following. Carry out reorganization of the ulcer or wound with chlorhexidine. On the surface of the defect impose a sterile gauze pad, place two emitters with magnetic nozzles. Carry out the irradiation of the infrared pulse laser radiation of a wavelength of 0.89 μm, a frequency of 2 Hz to 12 kHz for 5 minutes Then from a distance of not more than 5 mm perform remote irradiated simultaneously by laser radiation in the visible range of the spectrum and infrared pulsed radiation in the frequency range from 18 to 30 kHz. The wavelength of the used laser radiation of the visible range of the chosen phase of the process. After exposure to the ulcer or wound surface cause a wound covering. During this phase of necrosis and inflammation cause "liposorb" or "eleven", in the phase of purification and regeneration cause "digimon", and in phase epithelialization and scar - "gerison". Treatment of patients with venous ulcers spend on a background of reception of Detralex. In patients with the long festering wound in parallel use "NEOT NA".

The disadvantage of this method is that throughout the course remains marked perifocal edema, wound slowly cleared from the microflora is not local stimulation of the immune system, independent of the growth of epithelial (but not connective tissue).

The problem to which the invention is directed, creating a universal way of healing as trophic ulcers of different etiology and infected nonhealing wounds on unmodified tissue.

The technical result from the use of the invention is to improve the effectiveness of treatment by purification from microorganisms, drying the wound surface, a sharp decrease perifocal edema, stimulate the growth of epithelial cells on the edges of the wound, and on its free surface.

This result is achieved in that in the method of treatment of trophic ulcers and infected long-term non-healing wounds using radiation with the subsequent imposition of aseptic dressings flow of the argon plasma at a dose of 100-250 j/cm2placed at a distance of 10-25 cm from the treated ulcers or infected long-term unhealed wounds with an exposition on one of the irradiated field for 10-25 seconds, after processing the entire wound surface is led by its dynamic processing by AC the communication flow of the argon plasma at a distance of 10-20 cm in the dose of 80-150 j/cm 2across the surface of the wound until you see a glossy Shine" wound surface.

Treatment of trophic ulcers and infected nonhealing wounds is as follows.

The flow of the argon plasma at a dose of 100-250 j/cm2placed at a distance of 10-25 cm from the treated ulcers or infected long-term unhealed wounds with an exposition on one of the irradiated field for 10-25 seconds. After processing flow of the argon plasma in the described mode of the whole wound surface is led by its dynamic processing by moving the flow of the argon plasma at a distance of 10-20 cm in the dose of 80-150 j/cm2across the surface of the wound until you see a glossy Shine" wound surface. Then the wound closed aseptic bandage (for example, chlorhexidine water).

At a lower dose of the impact of the flow of the argon plasma is less than 100 j/cm2, a distance of more than 25 cm and the exposure time to less than 10 seconds sharply reduced therapeutic effect, at higher dose than 250 j/cm2, a distance of less than 10 cm and time of exposure to more than 25 seconds there is a threat of a thermal burn.

Were conducted clinical trials of the proposed method of treatment of trophic ulcers and infected nonhealing wounds at the medical center "Plasma" of Nizhny Novgorod.

When is EP 1. Patient K. 54 years, complained about the infected long-term unhealed wounds in the area of the right elbow bend. Suffers gormonzawisimah bronchial asthma. For the 6 months prior to treatment alone tried to introduce itself in a vein of calcium chloride in order to relieve the kinks, resulting in the emergence of postinjection cellulitis of the right forearm. Treated in General hospital, performed an autopsy phlegmon, sanitation purulent focus on the background of antibacterial therapy followed aytodermoplastics. Subsequently, there was a partial rejection of the skin flap, re-infection, wound suppuration.

An objective examination - infected wound in the area of the right elbow bend with moderate purulent discharge. After rehabilitation wounds 3%solution of hydrogen peroxide was performed processing flow of the argon plasma at a distance of 10 cm from the nozzle of the plasma torch (plasma - arc installation scalpel plasma SP - CCM" (license No. 99-03-001310, registration certificate number - 29/01070802/4902-03) with a radiation power of 100 j/cm2and exposure time of 25 seconds on one of the irradiated field. After treatment on the wound superimposed aseptic bandage. After 3 session disappeared perifocal edema around the wound, ulcer was purified from discharge. After 7 sessions began rasras is the W epithelium at the edges of the wound, to free the wound surface appeared Islands of epithelial tissue, gradually expanding. 16 the procedure, there was a complete closure of wounds of their own epithelial tissue. To date relapse and there are no complications.

Example 2. The patient that is 18 years old, came about sores in the area of both legs. Suffering from diabetes for 14 years, was repeatedly treated in surgical hospitals, performed how agressively to debride, antibacterial therapy. An objective examination: trophic ulcers on the anterior surface of both tibiae with abundant purulent discharge, purulent scabs. After recovery of trophic ulcers of 3%hydrogen peroxide solution was performed processing flow of the argon plasma at a distance of 25 cm from the nozzle of the plasma torch, with a radiated power of 250 j/cm2and the exposure time to 10 seconds in one of the irradiated field. After treatment for ulcers impose aseptic bandage. On the 5th session occurred cleansing the surface of ulcers, the disappearance of the discharge, with the subsequent closure of trophic ulcers own epithelial tissue 14 procedure.

Example 3. Patient D., 55 years old, came about diabetic foot, ulcers plantar surface of the right foot. Suffering from diabetes mellitus type 1 for 12 years. An objective examination - trophic what SWA on the plantar surface of the right foot. Carried out the processing described above ulcers flow of the argon plasma at a distance of 15 cm from the nozzle of the plasma torch with a radiation power of 200 j/cm2and the exposure time to 10 seconds in one of the irradiated field. After treatment on the wound applied with a sterile dressing. After 2 session disappeared perifocal edema around the wound, ulcer was purified from discharge. After 5 sessions began overgrowth of epithelium at the edges of the wound. 11 procedure, there was a complete closure of wounds of their own epithelial tissue.

Thus, the proposed method for the treatment of venous ulcers and infected nonhealing wounds increases the effectiveness of treatment by purification from microorganisms, drying the wound surface, a sharp decrease perifocal edema, stimulate the growth of epithelial cells on the edges of the wound, and on its free surface.

Treatment of trophic ulcers and infected long-term non-healing wounds using radiation with the subsequent imposition of aseptic dressings, characterized in that the flow of the argon plasma at a dose of 100-250 j/cm2placed at a distance of 10-25 cm from the treated ulcers or infected long-term unhealed wounds with an exposition on one of the irradiated field for 10-25 seconds, after processing the entire wound surface is led by its dynamic processing way of the flow of the argon plasma at a distance of 10-20 cm in the dose of 80-150 j/cm 2across the surface of the wound until you see a glossy Shine" wound surface.



 

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1 ex

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3 ex

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3 ex

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3 cl, 5 dwg

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4 cl

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EFFECT: complete destruction of neoplasm; excluded its further growth.

4 cl

FIELD: medicine.

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EFFECT: complete destruction of neoplasm; excluded tumor recurrence; reduced risk of tumor cells dissemination.

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FIELD: medicine.

SUBSTANCE: the present innovation deals with treating vascular cutaneous neoplasms, such as nevus flammeus and gemangiomas. Light-thermal impact at energy ranged 39-47 J/sq. cm should be performed in two stages, and between them, 2-3 wk after the onset of vascular resistance at the first stage one should perform beta-therapy daily for 2-3 d at single dosage being 20 g. Then, 3 wk later it is necessary to conduct the second stage of light-thermal impact by starting at energy value being 42 J/sq. cm, not less. The method enables to shorten therapy terms due to applying combined method to affect vascular cutaneous neoplasms.

EFFECT: higher therapeutic and cosmetic effect.

1 ex

FIELD: medicine.

SUBSTANCE: method involves intravitreously introducing two electrodes into intraocular neoplasm after carrying out vitrectomy and retinotomy to expose the intraocular neoplasm. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with current intensity of 100 mA during 1-10 min or 10 mA during 10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2.The transformed retina and tumor destruction products are intravitreally removed. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. Another embodiment of the invention involves adjusting position and size of the intraocular neoplasm in trans-scleral diaphanoscopic way. Rectangular scleral pocket is built above the intraocular neoplasm to 2/3 of sclera thickness with its base turned away from limb. Several electrodes are introduced into intraocular neoplasm structure via the built bed. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with the same current intensity in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. Superficial scleral flat is returned to its place and fixed with interrupted sutures. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg after having carried out vitrectomy and retinotomy. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2. The transformed retina and tumor destruction products are intravitreally removed using vitreotome. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. The number of electrodes is equal to 4-8.

EFFECT: reduced risk of metastasizing.

4 cl, 13 dwg

FIELD: medicine.

SUBSTANCE: method involves building tunnel to posterior eyeball pole in inferoexterior and superexterior quadrants. The tunnel is used for implanting flexible polymer magnetolaser implant to the place, the subretinal neovascular membrane is localized. The implant has a permanent magnet shaped as a cut ring and is provided with drug delivery system and a short focus scattering lens of laser radiator connected to light guide. The permanent implant magnet is axially magnetized and produces permanent magnetic field of 5-7 mTesla units intensity. It is arranged with its north pole turned towards sclera at the place of the subretinal neovascular membrane projection with extrascleral arrangement of laser radiator lens membrane being provided in the subretinal neovascular membrane projection area. The other implant end is sutured to sclera 5-6 mm far from the limb via holes made in advance. The implant is covered with conjunctiva and retention sutures are placed thereon. Light guide and drug supply system lead is attached to temple with any known method applied. Drugs are supplied via the implant drug supply system in retrobulbary way in any order. Triombrast is given in the amount of 0,4-0,6 ml and dexamethasone or dexone in the amount of 0,4-0,6 ml during 3-4 days every 12 h. 0.1-1% aqueous solution of khlorin is intravenously introduced at the third-fourth day after setting the implant as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, at a bolus dose of 0.8-1.1 mg/kg. Visual control of subretinal neovascular membrane cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the subretinal neovascular membrane with the photosensitizer to maximum saturation level, intravitreous, transretinal laser radiation of 661-666 nm large wavelength is applied at general dose of 30-120 J/cm2. The flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, samarium-iron-nitrogen or neodymium-iron-boron system material. The photosensitizer is repeatedly intravenously introduced at the same dose in 2-3 days after the first laser radiation treatment. Visual intraocular neoplasm cells fluorescence control is carried out using fluorescent diagnosis techniques. Maximum level of saturation with the photosensitizer being achieved in the subretinal neovascular membrane via laser light guide and implant lens, repeated laser irradiation of the subretinal neovascular membrane is carried out with radiation dose of 30-60 J/cm2.

EFFECT: accelerated subretinal edema and hemorrhages resorption; regression and obliteration of the subretinal neovascular membrane; prolonged vision function stabilization.

6 cl

FIELD: medicine.

SUBSTANCE: method involves filling vitreous cavity with perfluororganic compound. Two electrodes manufactured from platinum group metal are intravitreally, transretinally introduced into intraocular neoplasm. Electrochemical destruction is carried out with current intensity of 10-100 mA during 1-10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous, transretinal laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2 in perfluororganic compound medium. The transformed retina and tumor destruction products are intravitreally removed with perfluororganic compound volume being compensated with its additional introduction. Boundary-making endolasercoagulation of retinotomy area is carried out. The perfluororganic compound is substituted with silicon oil. The operation is ended in placing sutures over sclerotmy areas and over conjunctiva. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity. Platinum, iridium or rhodium are used as the platinum group metals.

EFFECT: complete destruction of neoplasm; reduced dissemination risk.

6 cl, 12 dwg

FIELD: medicine, applicable for stopping of pains of various nature.

SUBSTANCE: the device has a quantum-mechanical oscillator located in a casing, magnet, vessel for medicinal agent and a hollow cylinder. The magnet is installed between the oscillator and the vessel. Positioned in the vessel is a hollow cylinder having through holes on its surface.

EFFECT: quick and absolute anestesia.

2 ex, 1 dwg

FIELD: medicine.

SUBSTANCE: method involves administering laser radiation therapy once a day using low intensity pulsating radiation of wavelength equal to 890nmand power density of 0.03 mW/cm2. Injured organ projection to frontal abdominal wall is exposed to radiation at the first laser therapy stage in two fields acting upon each field for 2 min with radiation pulse succession frequency equal to 80 Hz in applying stable contact-type method. Total treatment dose on two fields is equal to 0.008 J/cm2. The second laser therapy stage begins immediately after having finished the first one in applying radiation along the large intestine path using labile contact-type method in a way that radiation pulse succession frequency equal to 80 Hz is applied first during 1 min and then frequencies of 600, 150 and 300 Hz are applied also during 1 min, respectively. Total treatment dose is equal to 0.032 J/cm2 at the second stage. Total treatment dose is equal to 0.04 J/cm2 at both stages.

EFFECT: enhanced effectiveness in inhibiting dysbacteriosis; reduced frequency of postoperative complications.

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