RU2424816C2 - Method of post-operation monitoring of patients after radiosurgical treatment of tumour-like lesions and benign neoplasms of oral cavity mucosa - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgical dentistry, and can be used for post-operational monitoring of patients after performed surgical treatment of tumour-like lesions and benign neoplasms of oral cavity mucosa. For this purpose in addition to drug therapy after end of operation on patient's wound surface ozonised oil solution is applied for 8-12 minutes with further performance of applications 3-4 times per day for 4-5 days.

EFFECT: carrying out applications in suggested regimen makes it possible to reduce treatment terms due to creation of favourable conditions for regeneration processes.

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Description

The invention relates to medicine, namely to surgical dentistry, and can be used for postoperative management of patients after surgical treatment of tumor-like lesions (leukoplakia) and benign neoplasms (squamous papilloma, papillary hyperplasia, fibroma) of the oral mucosa.

Neoplasms in the head and neck region account for 20-25% of tumors of all localizations (A.I. Paches). At the same time, over the past 10-15 years, the number of patients with tumors of the oral mucosa, which exceeds 5-7 cases per 100 thousand of the population, has more than doubled.

Most benign tumors are characterized by slow growth and an asymptomatic course, which is why patients turn to medical institutions at a relatively late date when pain or significant deformation and related functional disorders of chewing and speech appear.

The most common method of treating benign neoplasms of SOP is the surgical method, which provides for complete excision of the neoplasm within apparently healthy tissues. However, the effect of the surgical treatment is often reduced due to the presence of inflammatory phenomena in the area of the postoperative wound and slow regeneration, and subsequently the formation of a coarse retracted kelloid-altered scar tissue, which means an increase in the treatment time for such a patient and possible postoperative complications. Therefore, one of the pressing problems of modern surgical dentistry (and cosmetology) remains the search and development of the most effective methods of postoperative management of the patient.

At present, a radiosurgical method of treating these diseases has spread. In contrast to the surgical method - laborious and traumatic - the radiosurgical method allows simultaneous dissection with simultaneous coagulation of tissues. The portable radiosurgical device operates at a frequency of 3.8 MHz, the device has 4 operating modes - 3 different waveforms and a pulsation current.

Since during the operation a coagulating effect is achieved, there is no need to use hemostatic agents, which significantly reduces the invasiveness of the operation, simplifies its implementation and reduces the duration of the operation. Inflammation is reduced, since a tissue incision is performed without a burn and necrosis of the wound edges. Wound healing takes place by primary intention.

For the prototype of the present invention, a well-known method of postoperative management of patients after radiosurgical treatment of tumor-like lesions and benign neoplasms of the oral mucosa, including drug therapy (R. V. Ushakov et al. "The use of antibiotics in dental practice for the prevention of infectious and inflammatory complications" // Dentalforum 2004. - 1 (13). S.70-74).

As a rule, the postoperative period is accompanied by a mild pain syndrome, slight swelling of the surrounding soft tissues and mucous membrane, difficulty eating. In the oral cavity due to difficulty in hygiene, there is a constant accumulation of microflora, including etiotropic and supporting inflammation. The growth of microflora is restrained by the appointment of broad-spectrum antibacterial drugs. And this, in turn, also leads to negative consequences such as dysbiosis, microflora tolerance, weakening of general and local immunity, etc. As a result of such exposure from microorganisms in the postoperative period, the risk of recurrence of the disease and failure of regeneration due to a sufficiently long healing period that occurs by secondary intention in the interdental areas remains extremely high. Despite the widespread use as local therapy of antiseptics such as chlorhexidine bigluconate at a concentration of up to 0.1% or listerin, miramistin, as well as local use of antibiotics (Metrogil Denta, tetracyclines), the risk of disease recurrence after surgery remains quite high.

The objective of the invention is to reduce the treatment time by creating favorable conditions for the regeneration processes.

The problem is solved in that in the known method of postoperative management of patients after radiosurgical treatment of tumor-like lesions and benign neoplasms of the oral mucosa, including drug therapy, after the operation is completed, an ozonized oil solution is applied in a thin layer on the wound surface for 8-12 minutes, then applications are carried out 3-4 times a day for 4-5 days.

Currently, the effectiveness of the use of ozonated solutions is shown in various pathological conditions. This is due to the physicochemical and biological properties of ozone, which determine the bactericidal, antihypoxic, detoxification, immunocorrecting, membrane stabilizing effects and the absence of teratogenic, carcinogenic properties. Another positive point is the possibility of using it independently by patients and even at home, due to its simplicity and high economic efficiency. The antiseptic and regenerative properties of the ozonized oil solution we use (olive oil) are many times more active than in ozonated solutions, due to the formation of ozonated esters of unsaturated fatty acids, which have a longer effect on the biological substrate, and can also penetrate into tissues , give oxygen, thereby improving blood circulation in them, activating metabolic processes, contributing to granulation and epithelization of pathological foci. An ozonized oil solution was obtained by bubbling 50 ml of olive oil for 60 minutes with an ozone concentration of 2.0-2.5 mg / L using the medical ozonizer AOT-N-01-Arz-01/1, the shelf life in a dark dish in a cool place is 6 month

The present invention meets the criteria of "novelty" and "inventive step", as the patent information research conducted did not reveal the sources of patent and scientific literature that would discredit the novelty of the proposed technical solution. Studies have not identified technical solutions with significant features of the proposed method.

The invention when used gives the following positive effect:

- The use of ozonized oil solution has several advantages over traditional dosage forms - for a long time, the therapeutic concentration of the active substance in the area of the postoperative wound is maintained, it protects the wound surface due to the formation of a thin oil film, and accelerates cell regeneration. The pronounced bactericidal, membrane-stabilizing effects lead to the inhibition of the alteration phase, thereby completely suppressing the inflammatory phenomena. The ability to use at home makes the treatment process continuous.

The proposed method was applied in 30 patients with benign neoplasms of SOPR. As a result of treatment, a good condition of the wound was noted in the immediate postoperative period and in the regeneration period, the absence of inflammatory phenomena, the absence of severe pain, the absence of relapses when the surgical technique and doctor's recommendations were accurately performed, the absence of postoperative complications in the form of the formation of gross retracted keloid scars. The method is simple and affordable to use.

The method is as follows: postoperative management of the wound surface is carried out by local use of ozonized oil solution in the form of application therapy. Immediately after the operation, an ozonized oil solution is applied to the wound surface with a thin layer for 8-12 minutes. In the following days, application therapy is carried out 3-4 times a day for 4-5 days.

An example of a specific performance is given in the form of an extract from the medical history.

B. N., 45 years old, applied for prosthetics.

On examination, a neoplasm of milky white color with a rough surface is revealed. The focus of hyperkeratosis, located within the papillary-marginal part of the mucous membrane of the alveolar process of the lower jaw in the region of extracted 4.5, 4.6, 4.7 teeth, 1.5 × 0.8 cm in size. It is painless during palpation, is not removed during scraping.

Dental formula:

0 P P P P P P 0 8 7 6 5 four 3 2 one one 2 3 four 5 6 7 8 0 0 0 0 to to to P P 0

Diagnosis: leukoplakia of the mucous membrane of the alveolar bone, plaque form.

Treatment: excision of the neoplasm was performed within apparently unchanged tissues in regime No. 2 (incision-coagulation), with a power value of 5 units. Postoperative management was carried out for 5 days until complete epithelization of the wound surface. In the postoperative period, there were no inflammatory events in the area of operation. Healing occurred by primary intention. Application therapy with ozonized oil solution on the 1st day after the operation was carried out under control 3 times a day, on the following days by patients themselves. After 1.5 weeks, rational prosthetics was started.

As a result of observation for 1.5 years, there is no data for relapse.

Claims (1)

The method of postoperative management of patients after radiosurgical treatment of tumor-like lesions and benign neoplasms of the oral mucosa, including drug therapy, characterized in that after the operation is completed, an ozonized oil solution is applied in a thin layer on the wound surface for 8-12 minutes, then the application is carried out 3-4 times per day for 4-5 days.