DE102009015933A1 - Cavitation-assisted treatment of carbon dioxide problem wounds - Google Patents

Abstract

The treatment of germs / problem germs and / or the medical treatment of infections / problem infections, for example in wounds, is difficult or sometimes impossible because of resistance formation of the germs, through protective layers, no germs (eg biofilms, etc.) and / or other reasons , The solution is intended to bring about treatment with concentrated carbon dioxide together with a complementary sounding treatment with cavitation effect at low to medium sound energy, the cavitation has a supporting function, but does not sufficiently germicidal, the germicidal effect is based on a chemical reaction of carbon dioxide. To be used in the medical treatment of infections, especially infections caused by problematic germs. In the non-medical treatment of germs / problem germs for cleaning, hygiene, etc., also in the technical field.

Description

germs and infections by germs, especially problem germs and infections through problematic germs pose not only in medicine, but also in other areas of life science as well as technical / industrial Area an everyday, often not to handle getting problem. Infections with methicillin resistant Staphylococcus aureus (MRSA) and / or vancomycin-resistant Enterococci (VRE) are a serious challenge in the Treatment of infections. Also germ colonies, which are protected by "protective layers", for example by biofilms, small colony variants (SCV) and / or Protected by other protective layers, can be often difficult to treat.

The The following description provides a simple, effective and tissue-sparing solution for the purpose of germ killing in medical and / or non-medical germ treatment especially when handling problem germs / problem infections are, other forms of treatment / methods of germ killing and / or fail to treat infections and / or from different Reasons are not applicable and / or not applied should be. The offered treatment is simple and safe perform, for example, in the medical treatment of infected wounds, skin infections, bone infections and more.

It is a treatment with at least one suitable, per se, non-germicidal substance, but which is in the Interaction with at least one other suitable complementary Treatment (a treatment with mechanical and / or other physical and / or chemical and / or bioactive / biological / physiological adjuvant effect) can be germicidal effect. The Interaction of the appropriate substance and the complementary Treatment leads to a synergy effect resulting from the per se non-germicidal substance a germicidal makes acting material. The germicidal effect of the substance is based on properties of the substance itself, for example on its chemical properties, but not on the direct / immediate effect the complementary treatment and / or its adjuvant Effect.

Of the potentially germicidal active substance may under certain Conditions germicidal effect, the requirements To do so will be from the complementary treatment and / or through created one of its adjuvant effects. This complementary Treatment and / or its effects (at least one of its effects) has an auxiliary function, a supporting function, a preparatory function, a promotional function, a activating function (ie an adjuvant function / effect) without even - under the given treatment conditions - in sufficient extent / in sufficient number germicidal to act.

This becomes with carbon dioxide as a potentially germicidal substance and a complementary sound treatment with sound-induced Cavitation treatment (also adjuvant cavitation treatment) shown, the germ killing by properties of carbon dioxide but not by the effect of cavitation treatment, which under the given conditions as adjuvant treatment / effect not in sufficient number / sufficient extent (therapeutically relevant, therapeutically effective, hygienically relevant) germicidal can work.

carbon dioxide is usually one or not germicidal per se acting gas acting on germs / microorganisms, in particular by Protective layers protected germs, no / hardly germicidal Effect has to be suitable for killing germs, in particular of problem germs and / or treatment of infections / problem infections to appear to be particularly suitable. At most as an ingredient a Kavitationsmediums with germicidal effect a cavitation effect, for example in a cavitation treatment with high sound energy (power sound). But that is not here meant. This refers to the effect of carbon dioxide as germicidal acting substance in the interaction of carbon dioxide with a adjuvant cavitation treatment as described later.

Of the suitable, potentially germicidal substance is below in the description usually only called "substance". Carbon dioxide is always "stuff". "Stuff" can in the description can be replaced by carbon dioxide, "substance" can but also be another suitable substance. Another suitable treatment with at least one mechanical and / or other physical and / or chemical and / or bioactive effect is described below in the description also "complementary treatment", the effect also called "adjuvant". Sound = complementary Treatment, sound-induced cavitation = adjuvant effect / cavitation.

Summary

Carbon dioxide, as a relatively small molecule, can easily penetrate tissue (eg, skin), biological structures of germs / microorganisms (eg, through normal diffusion), which is normally harmless to germs. But if under special circumstances, one beyond the normal measure In addition, by the germ no longer regulated enrichment of carbon dioxide (for example, an accumulation of carbon dioxide in the cell interior of germs) takes place, then carbon dioxide can be germicidal effect under certain circumstances and is therefore called "potentially germicidal effect". This is part of the description, especially when with the use of carbon dioxide, which is preferably contained in a high concentration in a medium (eg water) complementary to the application of carbon dioxide at the same time and / or promptly a sound treatment with adjuvant Cavitation treatment of germs and / or their biological structures takes place, thereby created by the cavitation effect conditions / conditions that allow carbon dioxide germicidal effect, as a substance with its properties and not (causally, directly) by the Kavitationswirkung itself, this is only Involved indirectly. Especially when the cavitation is induced by sound with low to medium intensity / energy and the cavitation energy is insufficient to kill germs in sufficient numbers.

carbon dioxide as potentially germicidal acting gas in the interaction with a sound generated by sound, preferably by low-frequency ultrasound Cavitation becomes "cavitation-based potentially germicidal effect of carbon dioxide "named.

The cavitation has the task / function to change biological structures of germs such that, for example, carbon dioxide in the cell interior is enriched by germs and in the cytoplasm / cytosol by a dissociation reaction (corresponding DE 102 33 293 , Illustration 1 ) to cause a no longer regulatable by the germ lowering of the pH, which eventually leads to cell death. The "change" of biological structures of the germs by an adjuvant cavitation effect and the penetration of carbon dioxide into these structures, the penetration of carbon dioxide into the cell interior of the germs is an example of the interaction of cavitation and carbon dioxide. Cavitation creates the conditions for carbon dioxide to penetrate these structures into the cell interior of the germs. Another example of the interaction is that carbon dioxide, as a cavitation-effective component of the cavitation medium, participates in the cavitation and at the same time (at the same time) can act as a potentially germicidal substance.

The cavitation-based potentially germicidal Effect of carbon dioxide in the treatment of problematic germs and / or of problematic infections with a carbon dioxide-rich medium (which may or may not serve as cavitation medium) characterized in that as a result, in a Kavitationsmedium (z. B. the said medium), complementarily successful sound treatment the germ with cavitation effect on the germs, the carbon dioxide sufficient in one for a germicidal effect high concentration in the cell interior of the germs can accumulate to in the aqueous environment of the cytoplasm (cytosol) a reaction which leads to a strong hyperacidity, which can no longer be regulated by the germ Cytosols and thus leads to cell death.

If a cavitation medium is used as it is in the documents DE 10 233 293 . DE 10 2004 004 415 carbon dioxide is a cavitation-effective component of the cavitation medium and involved in cavitation (as "oscillating / oscillating gas bubbles"), while carbon dioxide is a potentially germicidal gas as part of the cavitation medium Cavitation medium new features, properties, applications.

carbon dioxide as potentially germicidal gas and carbon dioxide as a cavitation-effective component of the cavitation medium a sound-induced cavitation have by the interaction the cavitation effect and the effect of potentially germicidal acting synergistic effect with carbon dioxide alone and / or could not be reached by cavitation alone.

The cavitation treatment can be carried out simultaneously with the application of carbon dioxide, as shown in Figure 1 is shown schematically. The cavitation treatment can be carried out promptly with the use of carbon dioxide, as shown in Figure 2 is shown schematically.

Comments and definitions

cooperation in the sense of interaction, combination and vice versa.

function in terms of property, feature, task, purpose and vice versa.

circumstances in terms of conditions, conditions, conditions and vice versa.

treatment in terms of treatment form, treatment method and vice versa.

effect in the sense of reaction, consequence, effect, effect, influence, power, Energy and vice versa.

properties in the sense of characteristics, characteristics and vice versa.

adjuvant in the sense of supportive, helpful, complementary.

adjuvant in the sense of aids, aids ...

Complementary in the sense of supplementary, supplementary.

A complementary treatment of the description is, for example a sound treatment. This induces / produces an adjuvant / supportive acting cavitation / cavitation effect. A cavitation treatment / cavitation / cavitation effect the description has an adjuvant / supporting effect, for example, for carbon dioxide, for example, such that the cavitation creates conditions for that Carbon dioxide can be germicidal effect, namely not by the cavitation.

physiology the germs in terms of "the life processes" concerning at the functional level of, for example, cells, cell aggregates, these are, for example, control mechanisms, the metabolic processes, Cell division, etc. regulate and / or control.

physiology Physiological reactions, for example, are all life-regulating Processes. In sufficient numbers and / or in sufficient quantities and / or is sufficiently germicidal in the sense of therapeutic relevant, therapeutically effective, hygienically relevant.

One Active ingredient is a substance that is also low in an organism of humans and / or animals triggers a certain effect, z. B. a physiological reaction. For example, a pharmaceutical (pharmacologically active) drug such as a drug, a drug (in the broader sense drugs). Also substances for the killing of Germs belong to the active ingredients, for example as a drug (Medicines, medicines) but also other substances such as Disinfectants, some anti-infectives, etc., are agents but also such substances, for example, for cleaning / hygiene serve certain ingredients in cosmetics and others. Also in Field of crop protection. Pharmaceutical agent = drug, drug, Drug, z. As antibiotics, anti-infective agents, polyhexanide, rinsing solutions etc.

by se in the sense of itself, on its own, in itself, of yourself out, in itself

The Description is based on the gas carbon dioxide. Carbon dioxide explicitly as carbon dioxide. Carbon dioxide is a particularly preferred gas this description. Furthermore, carbon dioxide can be exemplary for another suitable gas and / or another suitable one Substance to be accepted. Potentially germicidal according to the previous and / or later description.

cavitation explicitly means cavitation. Cavitation can also be an example for another suitable complementary treatment with physical and / or chemical and / or bioactive action stand (without expressly mention). In the description Cavitation means preferably one by a complementary one Sonication induced cavitation, an effect of sound is therefore the cavitation effect.

problem germs are, for example, germs that are resistant to pharmaceutical agents and / or to another germicidal have formed active substance / active substance, for example MRSA, VRE and / or by a protective layer (eg biofilm, SCV, pus soil, Fibrin coating, etc.) against germicidal active substances / substances are protected u. a. m .. But also if other, conventional Treatments / methods of germ treatment fail / are ineffective and / or difficult to perform and / or not applied / performed can / should. Other equally important examples of Application and / or problem infections by problematic germs listed later. Problem infections are infections (for example from wounds) by problem germs. Are problem infections Such infections, which are conventional, conventional Methods and / or agents and / or devices not and / or not sufficient and / or very difficult to handle, for example not even by an ultrasound application with high sound energy (Performance sound) such as the ultrasonic debridement.

sound in the description means first sound of any Sound frequency, preferably sound in the description means ultrasound with at least one sound frequency between 20 kHz and 20 MHz, More preferably, sound in the specification means low frequency ultrasound with at least one sound frequency between 20 kHz and 800 kHz, even more preferably, sound in the specification means low frequency ultrasound with at least one sound frequency between 20 kHz and 150 kHz.

Germs (microorganisms) represent a biological system. Germs can all germs, preferably pathogen / facultative pathogens acting germs / microorganisms (eg anaerobic / aerobic bacteria, gram-negative / gram-positive bacteria, dermatophytes, yeasts, molds, dimorphic fungi and other microorganisms , possibly also viruses). Frequent infections / problem infections for example by Pseudomonas aeruginosa, Staphylococcus. aureus, Staphylococcus epidermidis, Escheria coli, Candida albicans and others.

structures biological systems (biological structures) can be used for Example cell walls / membranes and other components of Be germinating. Structures of biological systems (biological structures) may be biofilm, other protective coatings, etc. biological Structures as a protective layer / biological, mechanical barrier can for example biofilms. Biofilms (covering, mucous layer) can Germs embedded in multiple layers as a solid phase into a slimy matrix of extracellular polymeric substances / EPS / exopolysaccharides and water as hydrogel, in addition to polysaccharides also polypeptides, Proteins, lipids and other substances.

Further can also coverings from mixed forms of different organic and / or inorganic substances / substances / materials consist, for example, fibrin deposits, pus, mucus, necrotic material, bacteria, germs, cell debris, fluids, Blood, other biological material and / or other compounds / materials, mostly mostly organic material. Hard to treat small colony variants (CSV) of germs.

germicidal (germicidal) stands as (generic) term, for example also terms such as biocidal, antibacterial, disinfecting, antiseptic, bactericidal / bacteriostatic, fungicidal / fungistatic, virucidal / virustatic, toxic, antiseptic, cytotoxic / cytostatic, denaturing, etc.

cavitation, preferred is the milder form of cavitation, gas cavitation, at lower to medium sound intensity / sound energy to excite and with a suitable Kavitationsmedium (for example, "carbonic acid") better to control and one over the transient Cavitation shows better biocompatibility. The milder form gas bubble cavitation (gas cavitation, pseudo-cavitation, stable cavitation), is preferable for humans and animals and also easy to handle by laymen. The strength of this Cavitation should not be sufficient to provide sufficient germs Kill number (sufficient number means medical sufficient, therapeutically effective / necessary, in hygienic terms required, etc.).

in principle are all ways to create cavitation, to be possible. But preferably the sound-induced cavitation, Of which in particular by low-frequency ultrasound in the lower Frequency range (20 kHz-150 kHz) induced cavitation.

A cavitation-effective [cavitation-active, cavitation-involved, cavitation-capable, cavitation-effecting] component of a cavitation medium is, for example, a gas which contains cavitation medium (eg a liquid such as water, etc.) in the form of gas bubbles and / or cavitation medium molecular form (molecular) and / or dissolved in another form. Sound effects on the cavitation medium (eg as shown in Figure 1 ) Gas bubbles are excited to oscillations (oscillating gas bubbles) and / or gas bubbles are newly formed, which are then excited to Kavitationsschwingungen. Excitation of gas bubbles to a sound-induced cavitation. A gas which is contained in a cavitation medium as gas bubbles and / or molecularly (as a molecule) and / or in another form and (as a gas bubble supplier) can contribute to cavitation and / or contribute, for example by oscillating gas bubbles, is a cavitation-effective component a cavitation medium. It is part of the cavitation medium and is directly involved in cavitation processes.

Potentially germicidal are substances that are not normally Germicidal effective and for germination originally not provided, and usually for that Not used. Carbon dioxide per se is not / only low Germicidal gas.

in the Context of the description is carbon dioxide but potentially germicidal acting gas, because it under certain conditions on germs germicidal effect.

But not meant is the germ killing as a direct effect of a cavitation effect on germs at, for example, high sound energy / high-energy cavitation, z. B. by power sound (sound of very high intensity to over 300 W / cm ² ) induced high-energy cavitation. Not meant are other effects of cavitation and / or other sound effects that are germicidal. Not meant germicidal effects of pharmaceutical agents and / or other active substances that are germicidal per se, eg. As antibiotics, anti-infective agents, antiseptics, disinfectants (including ethanol, methanol and other, higher-valued alcohols, formaldehyde / formalin and other aldehydes, phenols, other disinfectants, denaturants / denaturing methods) etc .. Potentially germicidal in the sense of the description also means not in that at least one per se acting germicidal substance (eg an antibiotic) is contained in the cavitation medium and / or this substance is applied following a cavitation treatment and the germicidal effect is completely and / or predominantly due to this substance.

medical Treatment of wounds / infected wounds, for example diabetic Full, leg ulcers, bedsores, burns, traumatic wounds, surgical wounds, osteomyelitis (wound including bone infection, also known as Osteitis), stoma wounds and other wounds. Also for infection prophylaxis.

medical Treatment of germs, eg. As skin infections, nail bed infections etc .. Treatment of germs, for example, to disinfect, in Area of hygiene, cleaning, etc .. Treatment of germs in technical / industrial Area.

Further additional comments or definitions later elsewhere in the description.

cavitation medium

carbon dioxide in any concentration in water and / or in aqueous Solution and / or in another suitable liquid contained therein as gas bubbles and / or in other form therein. carbon dioxide dissolves very well in water, in aqueous solutions and some other (polar) liquids (eg alcohol, alcoholic solutions, acetone, serum, etc.), in which carbon dioxide, similar on water, can dissociate.

Highly preferred is water as a cavitation medium in which carbon dioxide in high to very high concentration (up to 1500 mg CO ₂ / l even up to 1500 mg CO ₂ / l at about 40 ° C and atmospheric pressure, and is partially supersaturated) is enriched and because of the dissociation of carbon dioxide in water (corresponding DE 102 33 293 . 1 ) can also be called "carbonic acid water". The carbon dioxide is contained therein partly as gas bubbles, but predominantly therein dissolved in molecular form (molecular) and / or contained in another form therein, for example in (fine) disperse form, in the form of associated molecules (cluster, aggregation, micelle form, others associated forms, etc.). The cavitation medium is stable to handle.

By Sound effect on the Kavitationsmedium be located therein Gas bubbles excited to cavitation vibrations (up to resonance vibrations) and / or cavitation-capable / resonant gas bubbles can be created by the action of sound newly formed in situ and oscillated by the sound to oscillate be stimulated. Said medium is a gas bubble source in which potentially (namely, when they are affected by the sound effect be formed in the cavitation medium) oscillatory Gas bubbles are available in large numbers. Potentially because gas bubbles in the medium, for example, under Sound effect, first arise. Due to the high concentration Of carbon dioxide in the medium can always new gas bubbles arise. The advantage of such a cavitation medium is also in that carbon dioxide by the molecular and / or finely dispersed Distribution in cavitation medium even in small hairline cracks, crevices, Pores, caverns, corridors of mechanical / biological structures (eg skin, biofilms and other protective layers of germs etc.) can penetrate what gas bubbles on this scale can not to be effective there (wherever the water is Carbon comes in and there is everywhere a cavitation possible).

Such a cavitation medium ("carbonic acid water") is described in detail in the documents DE 102 33 293 . DE 10 2004 004 415 , Recovery and / or production of such a cavitation medium are mentioned in the cited documents. There are also other applications, uses, treatment of biological systems called. The carbon dioxide concentration in "carbonic acid water" is equivalent to "high density"?

State of the art

• Literaturauswahl: Peschen M. et. al, „Low-frequency Ultrasound Treatment of Chronic Leg Ulcers in an Gutpatient Therapy”, Acta Derm Venereol 1997; 77: 311–314 . Weichenthal et al. „Low-frequency ultrasound treatment of chronic venous ulcers„Wound Rep Reg 1997; 5: 18–22 . Ottstadt et al. „Heilt subaqual applizierter niederfrequenter Ultraschall arteriell-venöse Ulcera cruris?”, Vasomed 1998; 10: 24–32 .

The treatment of wounds, the skin, superficial infections of the skin / wounds, etc., with ultrasound, especially with low frequency ultrasound, preferably as cavitation treatment in a cavitation medium, for example subaqual and non-contact in a water bath, has been publicly publicized at international congresses since about 1990 Service. These treatments were performed at low sound intensity up to 100 mW / cm ² . Schematic representation of a subaqual treatment in 1 ,

• Selected Literature: Peschen M. et. al, "Low-frequency Ultrasound Treatment of Chronic Leg Ulcers in Good Patient Therapy", Acta Derm Venereol 1997; 77: 311-314 , Weichenthal et al. "Low-frequency ultrasound treatment of chronic venous ulcers" Wound Rep Reg 1997; 5: 18-22 , Ottstadt et al. "Does Subaqual Low Frequency Ultrasound Heal Arterial Venous Ulcera Cruris?", Vasomed 1998; 10: 24-32 ,

The successful treatment of severely infected ulcers of low frequency ultrasound in tap water in combination with antiseptics has been known since at least 1990 and has been presented at several international congresses since 1991. Among them a very successful treatment of a patient with leg ulcers and severe bacterial plaque, micro- / macroangiopathy, diabetes mellitus, Werner syndrome. In this case tap water was used as the cavitation medium to which either one tibacterially active ingredient (PVP-iodine) was added and / or the drug was applied following the ultrasound treatment. The effect of low-frequency ultrasound treatment in conjunction with the topically applied active ingredient (eg PVP-iodine) was attributed to the effect of cavitation and brought the ulcer for healing.

The low-frequency ultrasound device used for the above-mentioned treatments, in particular the ultrasound device, corresponded in technically essential points to that described in US Pat EP 0335851 . EP 0595783 ,

The non-contact application of low-frequency ultrasound in the form of power sound with the help of a Flüssigkeitssaerosols for the treatment of diabetic gangrene was of Lindner et al. "Results and Experience with Performance Sound in the context of Complex Treatment of Diabetic Gangrene", Z. Klin. Med. 42 (1987); Issue 6: 503-506 described.

The Wound debridement with low frequency ultrasound followed later. Ultrasonic debridement occurs at high to very high sound intensity (power sound) and at the same time has a germicidal effect. A special one Cavitation medium is not necessary. This special treatment of wound debridement belongs in the hands of trained Professionals and is - in contrast to low frequency - ultrasonic treatment at low / medium sound intensity - not by anyone and not everywhere and involves certain risks.

Various Scientific publications describe that by cavitation (Especially by low frequency ultrasound in a cavitation medium induced cavitation) the structure of biological systems and / or biological structures (eg cell walls, biofilm etc. but also skin, stratum corneum, etc.), partly reversible, to Part permanently changed in such a way and in the biological Structures openings, channels, holes, Pores, caverns, passages (a kind of perforation) arise, by substances / externally supplied substances because of improved / increased permeability (permeability, Increasing the diffusion length [path length / distance a substance in a biological structure by diffusion / migration can go back]) into the structures, the structures penetrate (pass through / diffuse through and / or be transported through) Examples are the transdermal drug delivery (also known as sonophoresis), the improved efficacy of Antibiotics and other germicidal active ingredients in the treatment of wound infections.

The Transdermal application of carbon dioxide (for example applied as a gas or as a carbonic acid bath) for therapeutic and / or cosmetic treatment with beneficial physiological action (for example in circulatory disorders for vasodilation) has been known for many years. This carbon dioxide diffuses - probably on a molecular basis - through the skin into the tissue. With Gas bubbles could not do that. For example, it deals with arterial and / or venous circulatory disorders, arterial and / or venous leg ulcers (Ulcera cruris) etc.

therapeutic Also used for many years is the treatment of ulcers cruris in the combination of a subaqual low-frequency ultrasound treatment and the subaqualen treatment in a carbonic acid bath. Both treatments were subaqual, and so it was obvious, the different Effects of Low Frequency Ultrasound Treatment and Carbonation Treatment in a subaqual treatment to combine with each other.

at this combination of subaqual low frequency ultrasound treatment and subaquale carbonic acid treatment are not just the Effects of both individual treatments to bear, but the medium "carbon dioxide" / carbonic acid bath is at the same time a highly effective cavitation medium. "Carbonic acid water" in the Carbon dioxide dissolved in water and partially dissociated.

The basis is also the documents DE 102 33 293 . DE 10 2004 004 415 which, in addition to the description of a cavitation medium, also contain definitions and definitions that may / should be valid for this description.

The germ killing with carbon dioxide is used industrially, for example in the food industry. For example, by the action of highly concentrated, high-density carbon dioxide under high pressure on microorganisms, an accumulation of carbon dioxide in the germs (inside the cell) can be achieved, which then - allegedly by a no longer regulated by the microorganism pH change - lowering the pH - leads to the death of germs. Selected Literature: "Killing of Microorganisms by Compressed Carbon Dioxide". Dissertation (2005) for the degree of Doctor of Engineering at the Faculty of Mechanical Engineering of the Ruhr-University Bochum submitted by Reiner Daiminger from Burghausen ,

So far, the treatment of germs / problem germs has not been described, preferably the medical treatment of infections / problemin For the purpose of killing germs by a carbon dioxide application in conjunction with an adjuvant sound-induced cavitation treatment of the germs, wherein the effect of cavitation is not sufficient to kill germs by the cavitation in sufficient numbers. The germicidal effect is mainly based on the effect of carbon dioxide as a potentially germicidal gas.

Symptoms / Problem

• • Verminderte Wirksamkeit von Wirkstoffen/pharmazeutischen Wirkstoffen oder sogar Resistenzbildung der Keime gegenüber diesen Wirkstoffen, beispielsweise durch MRSA, VRE und andere.
• • Schutzschichten, beispielsweise Biofilme, die die Keime von externen Einflüssen abschirmen und beispielsweise deshalb topisch und/oder systemisch angewendete/verabreichte Wirkstoffe wirkungslos werden lassen.
• • Unerwünschte Nebenwirkungen, beispielsweise von Wirkstoffen, beispielsweise Allergiebildung, Unverträglichkeit, Belastung der Organe, Wechselwirkung mit anderen Medikamenten, Zellschädigung, Störung des Zellwachstums (z. B. von Granulationsgewebe) usw..
• • Bestimmte Behandlungsmethoden (z. B. Ultraschall-Debridement) nicht angewendet werden können und/oder nicht angewendet werden sollen. Beispielsweise wegen der Lokalisierung/dem Ort der Infektion, wegen unerwünschter Reaktionen bei/durch der/die Behandlung und/oder aus anderen Gründen.
• • Eine Behandlung nur durch dafür geschultem Personal durchzuführen ist, nicht aber zuhause durch den Patienten selbst usw...
• • Die Behandlung an bestimmte (teure) Behandlungsvorrichtungen/Behandlungsmethoden gebunden ist, die nicht überall vorhanden sind, nicht von jedem bedient werden können usw..

The treatment of germs / problem germs and / or the medical treatment of infections, especially infections by problematic germs are often a problem for the reasons exemplified below.

• • Reduced efficacy of active ingredients / pharmaceutical agents or even resistance of the germs to these agents, for example by MRSA, VRE and others.
• Protective layers, for example biofilms, which shield the germs from external influences and, for example, therefore make topically and / or systemically applied / administered active substances ineffective.
• • Undesirable side effects, for example of active substances, for example allergy formation, intolerance, stress on the organs, interaction with other drugs, cell damage, disruption of cell growth (eg of granulation tissue) etc.
• • Certain treatments (eg, ultrasound debridement) can not be used and / or should not be used. For example, because of the location / location of the infection, because of adverse reactions in / by the treatment and / or for other reasons.
• • Treatment should only be performed by trained personnel, but not at home by the patient, etc ...
• • The treatment is tied to certain (expensive) treatment devices / treatment methods that are not available everywhere, can not be used by anyone, etc ..

at the above industrial application of carbon dioxide to Germ treatment are several difficulties to overcome. The high / very high concentration of carbon dioxide in a medium. Overcoming mechanical barriers / protective layers of germs by carbon dioxide, the penetration of carbon dioxide in Barriers (eg protective layers) and their penetration, the enrichment of carbon dioxide in the cell interior of germs. Even these problems should be solved.

troubleshooting in the Treatment of germs / problematic germs and / or medical Treatment of infections / problem infections for the purpose of killing germs ..

The Germ killing by treating the germs with a potential Germicidal substance and a complementary Treatment with a supportive effect is based of carbon dioxide as a potentially germicidal Fabric and a complementary sound treatment with sound-induced Cavitation (adjuvant) as "cavitation-based, potential germicidal effect of carbon dioxide "described.

The cavitation-based potentially germicidal Effect of carbon dioxide, that is the germicidal effect of carbon dioxide on germs, preferably by a (usually in the cell interior (Cytoplasm) of the germs) effect caused by carbon dioxide / reaction physical and / or chemical and / or bioactive / physiological Way that leads to cell death. Being a sound-induced Cavitation (adjuvant) contributes / the conditions for it Creates that the carbon dioxide biological structures of germs penetrate, pass, overcome and enter the cell interior the germs can get. The cavitation-based potentially germicidal effect of carbon dioxide treated / affects the killing effect of carbon dioxide on germs and further, when, how and under what circumstances (conditions, Conditions) Carbon dioxide germs effectively on germs can be.

The cavitation-based potentially germicidal Effect of carbon dioxide in the treatment of problematic germs and / or of problematic infections with a carbon dioxide-rich medium. The medium can also serve as a cavitation medium. One to Carbon dioxide treatment complementary sound treatment with cavitation effect on the germs and / or on their biological Structures lead to changes (for example an increased permeability to external Substances) of biological structures (eg cell walls, Biofilms, other protective layers) such that carbon dioxide is present sufficient in one for a germicidal effect high concentration in the cell interior of the germs can accumulate to in the aqueous environment of the cytoplasm (cytosol) a reaction trigger a strong, no longer adjustable by the germ hyperacidity of the cytosol and thus leads to cell death.

Carbon dioxide can under certain conditions have a germicidal effect, namely, for example, if it is possible to bring carbon dioxide to the surface of the germs and especially in the germs / in the cell interior of the germs in a sufficiently large amount / in a sufficiently high concentration. The carbon dioxide is then in the aqueous environment of the cytoplasm (in the cytosol), dissociates (as shown 1 from document DE 102 33 293 ) and causes hyperacidity of the cytosol by lowering the pH. Due to the sufficiently high concentration of carbon dioxide (sufficiently high concentration to achieve this effect) in the cell interior of the germs / cytoplasm, the germ can no longer regulate the hyperacidity and dies off. That is, carbon dioxide interferes with the normal physiological life processes / regulatory mechanisms (in the physiology) of the germs and leads to changes in / on the germ and / or in the cytoplasm / cytosol what the germ attempts to repair / correct / regulate, but what because of the massive interference caused by the sufficiently high concentration of carbon dioxide is not possible (regulates to death) and this leads to cell death [current state of knowledge]. The germicidal effect is based in this case on a chemical reaction / action of carbon dioxide and water, but not on a Kavitationswirkung, z. B. in contrast to the power sound (ultrasonic debridement, ultrasonic disintegrator) not on a mechanical destruction of the germs by cavitation.

By an accompanying adjuvant sound-induced cavitation treatment conditions are created for carbon dioxide enriched in the germs and / or in a sufficiently high concentration can be introduced into the cell interior of the germs. For example the effect of the cavitation treatment causes biological structures (In the simplest case, these are cell walls, otherwise biofilms and other protective layers) such as, for example changed mechanically, leaving carbon dioxide in these structures can penetrate, these structures can pass, permeate, if these structures include cell walls / membranes are, from the outside (from the surface of the germs) to get into the cell interior of the germs. If these structures include biofilms, Coverings and / or other protective coatings are carbon dioxide from the surrounding medium penetrate into these protective layers, these penetrate and first in the environment / on the surface of the Germs can accumulate / concentrate, then into the cell interior of the Germs to arrive / be introduced. Additional effects / effects of sound and / or cavitation can these mentioned processes transport / accelerate (eg microflow, including micro massage, pressure / tensile effects, mass transport, Flow phenomena, pressing of substances into Matter, etc., also effects of biological / physiological, mechanical / physical, chemical type. An accumulation of carbon dioxide on and / or in the germs may be due to high carbon dioxide concentration in the medium, by high partial pressure, by diffusion, etc. take place. Especially but by the effect / effects of sound and / or cavitation, for example, by the sound pressure, by flow effects, local compression of carbon dioxide, driving in carbon dioxide in biological structures, etc.). Carbon dioxide can therefore be actively transported become. Also cavitation in the cell interior of the germs in enriched Carbon dioxide in the germs may play a role. u. a.).

Prefers will therefore be, for example, when carbon dioxide cavitation effective Part of a Kavitationsmediums is, of which preferably named as "carbon dioxide" Cavitation. In the "carbonic acid water" lies Carbon dioxide also in high concentration in molecularly dissolved Form before.

The Sound-induced cavitation (preferably a gas cavitation) should by sound of low to medium energy / intensity be stimulated. Sufficient to produce usable cavitation, but not sufficient to germs in sufficient numbers by the effect to kill the cavitation. Sufficient for a usable To generate cavitation means that by the effect of Cavitation on the biological structures of the germs, for example a mechanical change of the structures is effected. That is, the structures (for example, protective layers) become more permeable to at least one externally supplied substance, for example for carbon dioxide. If a cavitation medium is used in the treatment, such as it is previously described, for example, as "carbonic acid water", so the carbon dioxide can continue during the treatment penetrate into the biological structures and by cavitation the Loosen structures and change them so that more carbon dioxide is absorbed these structures penetrate, penetrate and possibly can destroy, with the aim that carbon dioxide the germs can reach, is enriched to the germs around in the germs (to enter the cell interior) / to be introduced. The effect cavitation and the effect of carbon dioxide as potentially germicidal active substances have a synergistic effect. The cavitation medium with Carbon dioxide as a cavitation-effective component has itself, by the carbon dioxide, a potentially germicidal effect and becomes synergistically effective.

If a cavitation medium is used in the treatment, as described above, for example, as "carbonic acid water", then carbon dioxide is a cavitation-effective component of the cavitation medium (eg involved as "oscillating gas bubbles" in the cavitation processes) and at the same time a potentially germicidal substance. Carbon dioxide, as a cavitation-effective component of the cavitation medium, acts as a cavitation effect and carbon dioxide also acts as a germicidal substance effective and synergistic (by the same gas) through the interaction of these effects. Carbon dioxide, as a cavitation-effective component of the cavitation medium, has cavitation effects on the germs and / or on their biological structures. This effect leads to changes in the germs and / or in the biological structures of the germs. These changes are a prerequisite for carbon dioxide to have a germicidal effect. Only through the interaction of carbon dioxide as a cavitation-effective component with cavitation effect and as a potentially germ-killing substance, an effect is achieved, which would not be possible without the interaction. This is not to be confused with a cavitation treatment in which the cavitation itself germicides.

The simultaneous (simultaneous) application of carbon dioxide as a cavitation-effective component of a cavitation medium and as a potentially germ-destroying gas / active substance is exemplified by the arrangement in FIG 1 , 1 shows one of the possible arrangements of a treatment with a potentially germicidal substance and at least one complementary treatment (in the example carbon dioxide and sound / cavitation). Arrangement of object, in the example a leg / foot immersed in a cavitation medium for a subaquale ("underwater") treatment and a (in this example) also immersed in the Kavitationsmedium sound applicator by sound / sound on / generates cavitation in the cavitation medium, for example by the sound effect in the cavitation medium gas bubbles are excited to cavitation oscillations (oscillating gas bubbles) and / or gas bubbles are formed by the sound effect, which are then excited to vibrate, in this example, the cavitation predominantly ( preferably) takes place in the layer between the object / the object surface and the sound-emitting surface of the sound applicator. In order to allow the cavitation to be close to and / or on the object surface, the layer (distance sound-emitting surface to the object surface) should be as small as possible.

The Cavitation itself should not / only slightly germicidal effect be / can be, for. B. because of too low a sound intensity and thus not sufficient energy-rich cavitation. This means, the germicidal effect of such a treatment should not / only to a limited extent by mechanical forces, which lead to the destruction of the germs, but completely / predominantly based on the potential germicidal effect of carbon dioxide. In this example, carbon dioxide is a cavitation-effective component of the cavitation medium and at the same time a potentially germicidal acting gas. The cavitation medium (containing carbon dioxide) is a potentially germicidal cavitation medium.

Case study of a treatment of a bacterially infected wound, e.g. B. in the Achilles tendon as in 1 shown. This wound is covered with a protective layer, so that drugs (antibiotics, drugs, drugs and / or other drugs) in topical and / or systemic application of the drugs neither the wound nor the germs can reach and thus remain ineffective. Sharp wound debridement (eg due to ultrasound debridement) should / must be avoided. Thus, the infected wound can not be treated effectively enough and the germs can not be killed. An easily performed sound-induced cavitation treatment in a carbon dioxide-containing cavitation medium can bring the solution. Due to the cavitation effect on the protective layers (biological structures) and / or on the germs, these protective layers are initially mechanically modified superficially in their structure (eg by crack formation, hair / capillary cracks, etc.), biofilms already show a corresponding topography with aisles , Pores, caverns, etc. into which carbon dioxide can penetrate), so that the cavitation medium can penetrate into these protective layers. Since the cavitation medium contains molecularly and / or finely dispersed carbon dioxide in a high concentration, cavitation can also be produced in the hair / capillary cracks, and the destruction of the protective layer can be continued (gas bubbles could not or only to a lesser extent because of their size Number in the fine cracks, capillary cracks penetrate). As a result, the structure of the protective layer is further loosened, more cavitation medium, more carbon dioxide penetrates into the protective layer, this loosens further by cavitation and reaches the germs around them in a similar manner (eg, their protective covers, membranes, cell walls) attack. Carbon dioxide can accumulate on and / or in the germs and unfold with this / by the enrichment a germicidal effect. Possibly the penetration of the protective layers with the cavitation medium / carbon dioxide and / or the accumulation of carbon dioxide in the germs is promoted by further effects / effects by / of low-frequency ultrasound and / or cavitation, eg. B. by microflows.

As one of the other possible arrangements schematically shows the figure 2 the timely, non-simultaneous application of a cavitation treatment and a carbon dioxide treatment. The use of carbon dioxide as a germicidal active ingredient is not carried out simultaneously with the cavitation treatment, but the use of (highly concentrated) carbon dioxide (as gas, gas mixture, water / gas mixture / mist, aerosol, etc.) takes place, for example, shortly after a cavitation treatment. First, a cavitation treatment (eg subaqual with a cavitation medium containing no or insufficient carbon dioxide) is followed by treatment with carbon dioxide, for example in a pressure chamber containing carbon dioxide.

• • gekennzeichnet dadurch, dass die Behandlung von Keimen und/oder von deren biologischen Strukturen mit mindestens einem potentiell keimabtötend wirksamen Stoff – wobei der Stoff per se nicht keimtötend wirkend ist – in der Zusammenwirkung mit mindestens einer komplementären Behandlung – einer Behandlung mit mechanischer und/oder anderer physikalischer und/oder chemischer und/oder anderer Wirkung (adjuvante Wirkung) – keimabtötend wirksam werden kann, wobei die komplementäre Behandlung und/oder mindestens einer ihrer Wirkungen Voraussetzungen dafür schafft, dass der Stoff keimtötend wirksam werden kann, ohne dass die komplementäre Behandlung und/oder mindestens eine ihrer Wirkungen selbst ausreichend keimtötend wirkt. Der Stoff ist bevorzugt Kohlendioxid, die komplementäre Behandlung bevorzugt eine Schallbehandlung, mindestens eine Wirkung der Schallbehandlung ist die einer schallinduzierten Kavitation.
• • Die kavitationsgestützte potentiell keimabtötende Wirkung von Kohlendioxid bei der Behandlung von Problemkeimen und/oder von Probleminfektionen mit einem mit Kohlendioxid stark angereichertem Medium ist dadurch gekennzeichnet, dass infolge einer in einem Kavitationsmedium komplementär erfolgenden Schallbehandlung der Keime mit Kavitationswirkung auf die Keime, das Kohlendioxid sich in einer für eine keimtötende Wirkung ausreichend hohen Konzentration im Zellinneren der Keime anreichern kann, um im wässrigen Milieu des Zytoplasma (Zytosol) eine Reaktion auszulösen, die zu einer starken, vom Keim nicht mehr regulierbaren Übersäuerung des Zytoplasmas/Zytosols und damit zum Zelltod führt. Bevorzugt ist das Kavitationsmedium mit dem mit Kohlendioxid stark angereicherten Medium, das zur Behandlung der Keime/Infektionen dient identisch.
• • Gekennzeichnet durch eine Behandlung/Anwendung von Kohlendioxid in/mit einem Medium, das Kohlendioxid in hoher/sehr hoher Konzentration enthält, beispielsweise das beschriebene Kavitationsmedium auch „Kohlensäurewasser” genannt, wobei das Medium eine Kohlendioxidquelle darstellt, die bevorzugt Kohlendioxid als einen kavitationswirksamen Bestandteil für die Kavitation zur Verfügung stellt wie auch Kohlendioxid, das sich in den Keimen ansammeln und keimtötend wirken soll. Kohlendioxid bevorzugt also mindestens bi-funktional wirksam ist.
• • Gekennzeichnet durch eine zur Anwendung von Kohlendioxid komplementären Behandlung mit mindestens einer mechanischen und/oder anderen physikalischen und/oder chemischen und/oder bioaktiven Wirkung. Beispielsweise eine komplementäre Schallbehandlung mit einer Kavitationswirkung.
• • Gekennzeichnet durch eine komplementäre Schallbehandlung mit adjuvanter schallinduzierter Kavitationswirkung.
• • Gekennzeichnet dadurch, dass die Keimabtötung auf einer physikalischen und/oder chemischen und/oder bioaktiven Wirkung/Reaktion und/oder auf Eigenschaften von Kohlendioxid beruht, nicht aber ursächlich/direkt/unmittelbar auf der Wirkung der adjuvanten Kavitationsbehandlung, also nicht (überwiegend nicht) durch eine mechanische Zerstörung der Keime durch mechanische Kräfte.
• • Gekennzeichnet dadurch, dass Kohlendioxid in die Physiologie des Keimes [die Lebensvorgänge betreffend auf der Funktionsebene von beispielsweise Zellen, Zellverbänden, das sind beispielsweise Regelmechanismen die die Stoffwechselvorgänge, Zellteilung usw. regeln und/oder steuern] derart eingreift, dass dies zum Zelltod führt, die komplementäre Behandlung (z. B. Schall) und/oder deren adjuvante Wirkung (z. B. Kavitation) aber am Zelltod nicht direkt/unmittelbar beteiligt ist.
• • Die kavitationsgestützte potentiell keimabtötende Wirkung von Kohlendioxid bei der Behandlung von Keimen und/oder von Infektionen ist gekennzeichnet dadurch, dass Kohlendioxid, das bei der Behandlung in einem kohlendioxidhaltigen Medium angewendet wird, dann keimtötende Wirkung hat, wenn mit Hilfe einer unterstützend wirkenden Kavitationswirkung auf die Keime und/oder auf deren biologischen Strukturen wie Zellwände, Biofilme, andere Schutzschichten Kohlendioxid im Zytoplasma/im wässrigen Zytosol der Keime in einer für eine keimtötende Wirkung ausreichenden Menge anreichern und das angereicherte Kohlendioxid in die Physiologie der Keime derart eingreifen kann, dass dies durch eine Übersäuerung des Zytosols zum Zelltod führt, die Kavitation aber am Zelltod nicht unmittelbar beteiligt ist, die Keimabtötung also nicht durch eine Kavitationswirkung erfolgt sondern durch eine Wirkung des Kohlendioxids.
• • Die kavitationsgestützte potentiell keimabtötende Wirkung von Kohlendioxid bei der Behandlung von Keimen und/oder von Infektionen ist gekennzeichnet dadurch, dass Kohlendioxid, wenn eine unterstützende, adjuvante Kavitationswirkung auf die Keime und/oder deren biologischen Strukturen wie Zellwände, Biofilme, andere Schutzschichten die Voraussetzungen dafür schafft, dass sich Kohlendioxid im Zytoplasma der Keime anreichern und das angereicherte Kohlendioxid in die Physiologie der Keime [die Lebensvorgänge betreffend auf der Funktionsebene von beispielsweise Zellen, Zellverbänden, das sind beispielsweise Regelmechanismen die die Stoffwechselvorgänge, Zellteilung usw. regeln und/oder steuern] derart eingreifen kann, dass dies zum Zelltod führt, die Kavitation aber am Zelltod nicht unmittelbar beteiligt ist, die Keimabtötung also nicht durch eine Kavitationswirkung erfolgt sondern durch eine Wirkung des Kohlendioxids.
• • Gekennzeichnet dadurch, dass Kohlendioxid keimabtötend wirken kann, wenn Kohlendioxid in ausreichend großer Menge/in ausreichend hoher Konzentration an/in Keime/in das Zellinnere von Keimen eingebracht wird.
• • Gekennzeichnet dadurch, dass Kohlendioxid keimabtötend wirken kann, wenn das ins Zellinnere eingebrachte Kohlendioxid sich im Zytosol löst, dissoziiert und damit eine Übersäuerung des Zytosols durch eine Absenkung das pH-Werts bewirkt. Diese Übersäuerung durch die physiologischen Regelmechanismen des Keims – wegen der hohen Konzentration nicht mehr korrigiert werden kann und dies dann zum Zelltod führt.
• • Gekennzeichnet dadurch, dass die Wirkung einer Kavitationsbehandlung auf Keime und/oder auf ihre biologischen Strukturen die Voraussetzung dafür schafft, dass Kohlendioxid an und in die Keime gelangen kann.
• • Gekennzeichnet dadurch, dass diese Voraussetzungen Veränderungen, bevorzugt mechanische Veränderungen, an biologischen Strukturen sind, die es einem externen Stoff erlauben, in diese Strukturen einzudringen, sie zu durchdringen und zu passieren/überwinden.
• • Gekennzeichnet dadurch, dass durch die unterstützende Wirkung einer adjuvanten Kavitationsbehandlung das Kohlendioxid sich an Keimen anreichern, Zellwände passieren und in ausreichend großer Menge im Zellinneren/Zytoplasma der Keime angereichert wird.
• • Gekennzeichnet dadurch, dass durch die unterstützende und/oder vorbereitende Wirkung einer adjuvanten Kavitationsbehandlung das Kohlendioxid durch biologische Strukturen gelangen kann, auch wenn die Keime durch Schutzschichten (Biofilm, SCV und/oder andere Beläge) ursprünglich, vor Kohlendioxid, geschützt sind.
• • Gekennzeichnet dadurch, dass Kohlendioxid bei der Anwendung in ausreichend hoher Konzentration im Medium (Kavitationsmedium, Nebel, Aerosol u. a.) zur Verfügung steht, bevorzugt als kavitationswirksamer Bestandteil eines Kavitationsmediums, beispielsweise als „Kohlensäurewasser”.
• • Gekennzeichnet dadurch, dass ein ursprünglich nicht/nur gering keimabtötend wirksamer Stoff, wie beispielsweise das bevorzugte Kohlendioxid, unter bestimmten Voraussetzungen (wie beschrieben) keimabtötend wirksam werden kann, deshalb potentiell keimabtötend wirksam genannt wird.
• • Gekennzeichnet dadurch, dass durch mindestens eine komplementäre Behandlung mit physikalischer und/oder chemischer und/oder biologischer/physiologischer (bioaktiver) und/oder anderer Wirkung, beispielsweise bevorzugt durch Schall und schallinduzierter Kavitation/Kavitationswirkung Voraussetzungen geschaffen werden, die einen geeigneten Stoff wie das bevorzugte Kohlendioxid keimabtötend wirksam werden lassen.
• • Gekennzeichnet durch einen Stoff, der potentiell keimabtötend wirksam werden kann und gleichzeitig durch eine vollkommen andere Wirkung die Voraussetzungen dafür schafft, dass der Stoff keimtötend wirksam werden kann, beispielsweise dadurch, dass der Stoff durch eine Wirkung biologische Strukturen von Keimen mechanisch verändert und somit die Voraussetzungen schafft, dass derselbe Stoff in die Keime eindringen und dort durch mindestens eine weitere Reaktion/Wirkung keimabtötend wirken kann, bevorzugt der Stoff Kohlendioxid ist. Wie das bei Kohlendioxid der Fall ist, das als kavitationswirksamer Bestandteil eines Kavitationsmediums durch Kavitationswirkung die Voraussetzungen dafür schafft, dass das Kohlendioxid als Bestandteil des Kavitationsmediums keimabtötend wirksam werden kann, indem es in die Keime eindringen kann, um dort seine keimabtötende Wirkung zu entfalten.
• • Gekennzeichnet durch eine Synergiewirkung zwischen Kohlendioxid als potentiell keimtötend wirkendem Stoff und Kohlendioxid als kavitationswirksames Gas. Synergiewirkung zwischen kavitationswirksamen Kohlendioxid und potentiell keimtötend wirkendem Kohlendioxid. Das sind zwei unterschiedliche Wirkungen von demselben Gas, die bei zeitgleicher und/oder zeitnaher Anwendung/Wirkung eine Synergiewirkung zeigen/haben kann (zeigt/hat).
• • Gekennzeichnet durch einen Stoff, bevorzugt Kohlendioxid, der/das durch mindestens zwei unterschiedliche Wirkungen des gleichen Stoffes, beispielsweise die Wirkung der Kavitation und die keimabtötende Wirkung, der Stoff selbst eine Synergiewirkung hat. Der Stoff, bevorzugt Kohlendioxid, synergistisch wirksam ist, besonders wenn der Stoff, bevorzugt Kohlendioxid, kavitationswirksamer und potentiell keimabtötend wirkender Bestandteil eines Kavitationsmediums ist. Dies gilt ganz besonders bei einer Kavitationsbehandlung in Anwesenheit dieses Stoffes, bevorzugt von Kohlendioxid.
• • Gekennzeichnet durch ein Kavitationsmedium, das durch denselben Stoff (bevorzugt ist dies Kohlendioxid) als Bestandteil des Kavitationsmediums mindestens zwei unterschiedliche Funktionen und/oder Wirkungen hat, die auf unterschiedliche Wirkweisen dieses einen Stoffes zurückzuführen sind und diese Wirkweisen sich gegenseitig ergänzen und zusammen zu einer Synergiewirkung durch denselben/den gleichen Stoff führt. Mit Kohlendioxid als kavitationswirksamer Bestandteil eines Kavitationsmediums kann durch Schall im Kavitationsmedium eine Kavitation induziert werden (das ist eine Wirkweise von Kohlendioxid), diese Kavitation hat unter Beteiligung von Kohlendioxid bei der Behandlung von Keimen und/oder ihrer biologischen Strukturen u. a. eine mechanische Wirkung auf die Strukturen und führt zu Veränderungen an den Strukturen, durch die das Kohlendioxid an und in die Keime gelangen kann, um dort angereichert zu werden. Im Zellinneren der Keime löst sich Kohlendioxid in der Zellflüssigkeit und dissoziiert bei einer pH-Wert Absenkung (zweite Wirkweise). Die pH-Wert Absenkung hat keimtötende Wirkung (Wirkweise von Kohlendioxid) und führt zum Zelltod der Keime. Die Anreicherung von Kohlendioxid und die Keimabtötung wäre ohne die Wirkung der Kavitation, an der Kohlendioxid maßgeblich beteiligt ist, nicht möglich. Das Zusammenwirken verschiedener Wirkweisen von Kohlendioxid hat zu einer Synergiewirkung geführt/wirkt synergistisch.
• • Gekennzeichnet durch eine Synergiewirkung einer Kavitationsbehandlung mit einem kohlendioxidhaltigen Kavitationsmedium.
• • Gekennzeichnet durch ein Kavitationsmedium, das mindestens einen synergistisch wirksamen Stoff als Bestandteil enthält, bevorzugt ist der Stoff Kohlendioxid. Synergistisch wirksam deshalb, weil der Stoff mindestens zwei unterschiedliche Wirkungen, und indem diese Wirkungen zusammenwirken, auch eine Synergiewirkung hat.
• • Gekennzeichnet durch ein Kavitationsmedium mit innerer, eigener Synergiewirkung, indem ein Stoff kavitationswirksamer Bestandteil des Kavitationsmediums ist und gleichzeitig potentiell keimabtötend wirkt und weder Kavitation noch Stoff für sich alleine keimabtötend wirksam sind/wären.
• • Gekennzeichnet durch ein Kavitationsmedium mit neuen Eigenschaften, Merkmalen, Anwendungen. Beispielsweise mit potentiell keimabtötender Wirkung. Beispielsweise mit Synergiewirkung.
• • Gekennzeichnet durch eine Anwendung von Kohlendioxid, die zeitgleich und/oder zeitnah zur Kavitationsbehandlung erfolgt.
• • Gekennzeichnet bevorzugt durch die Verwendung eines Kavitationsmediums, bei welchem Kohlendioxid ein kavitationswirksamer Bestandteil ist und ein potentiell keimabtötend wirkender und/oder ein zusätzlich therapeutisch physiologisch wirkender Stoff ist.
• • Gekennzeichnet dadurch, dass die Behandlung subaqual, entsprechend der Abbildung 1 und/oder der zu 1 gehörigen und/oder sich darauf beziehenden Beschreibung, erfolgen kann. Und/oder in einer auf Basis der subaqualen Behandlung und der damit beschriebenen Anordnung zugrundeliegenden, aber abgewandelten Form, erfolgen kann.
• • Das Kavitationsmedium ist gekennzeichnet durch weitere mögliche therapeutische Wirkungen, beispielsweise physiologischer Wirkungen des darin gelösten Gases (z. B. Kohlendioxid).
• • Gekennzeichnet, dass das mit Kohlendioxid stark angereicherte Medium zur Behandlung der Problemkeime und Probleminfektionen bevorzugt identisch ist mit dem Kavitationsmedium und bevorzugt aus Wasser und/oder aus einer wässrigen Lösung besteht, in der Kohlendioxid in hoher bis sehr hoher Konzentration gelöst ist, bevorzugt in einer Konzentration 1500 mg/l, sogar über 1500 mg/l.
• • Gekennzeichnet, dass sdie Kavitationswirkung auf die Problemkeime/Probleminfektionen durch die Behandlung im Kavitationsmedium und die Behandlung der Keime mit potentiell keimabtötend wirkendem Kohlendioxid gleichzeitig, zeitgleich im gleichen Medium erfolgen.
• • Gekennzeichnet, dass das Kavitationsmedium ein Medium ist, bei welchem das darin gelöste Kohlendioxid an der Kavitation, als kavitationswirksamer Bestandteil, beteiligt ist und gleichzeitig als keimtötend wirkender Stoff im Kavitationsmedium enthalten ist, das Kohlendioxid im Kavitationsmedium mindestens zwei unterschiedliche Wirkungen hat, die der Kavitationswirkung und die des keimtötend wirkenden Stoffes und beide Wirkungen sich synergistisch ergänzen.
• • Gekennzeichnet, dass das Kavitationsmedium durch das darin gelöste Kohlendioxid mindestens zwei unterschiedliche Wirkungen hat, die zusammen eine Synergiewirkung haben.
• • Gekennzeichnet, dass die Schallbehandlung aus im Kavitationsmedium aus eine unterstützend wirkende Kavitation induziert derart, dass die Kavitation/Kavitationswirkung auf die biologischen Strukturen der Keime, bevorzugt auf Zellwände, Biofilme und andere Schutzschichten, einwirkt, bevorzugt mechanisch einwirkt, um sie für extern zugeführte Stoffe wie das Kohlendioxid durchlässig zu machen mit dem Ziel, Kohlendioxid im Zellinneren anzureichern, um dadurch den Zelltod herbeizuführen.

The cavitation-based, potentially germicidal effect of carbon dioxide is:

• Characterized in that the treatment of germs and / or their biological structures with at least one potentially germicidal substance - the substance per se is not germicidal - in interaction with at least one complementary treatment - a treatment with mechanical and / or other physical and / or chemical and / or other action (adjuvant effect) - can be germicidal effect, the complementary treatment and / or at least one of its effects creates conditions that the substance can be germicidal effect, without the complementary treatment and / or at least one of its effects is itself sufficiently germicidal. The substance is preferably carbon dioxide, the complementary treatment preferably a sonication, at least one effect of the sonication is that of a sound-induced cavitation.
• The cavitation-based potential germicidal effect of carbon dioxide in the treatment of problematic germs and / or problematic infections with a carbon dioxide strongly enriched medium is characterized in that due to a complementary in a cavitation medium sound treatment of the germs with Kavitationswirkung on the germs, the carbon dioxide in a concentration sufficient for a germicidal effect in the cell interior of the germs can accumulate to trigger a reaction in the aqueous environment of the cytoplasm (cytosol), which leads to a strong, no longer regulated by the germ hyperacidity of the cytoplasm / cytosol and thus cell death. The cavitation medium is preferably identical to the carbon dioxide-rich medium which is used to treat the germs / infections.
• Characterized by a treatment / application of carbon dioxide in / with a medium containing carbon dioxide in high / very high concentration, for example the described cavitation medium also called "carbonic acid water", wherein the medium is a carbon dioxide source, preferably carbon dioxide as a cavitation effective ingredient for The cavitation provides as well as carbon dioxide, which should accumulate in the germs and germicidal effect. Carbon dioxide is therefore preferably at least bi-functional effective.
• Characterized by a complementary to the application of carbon dioxide treatment with at least one mechanical and / or other physical and / or chemical and / or bioactive effect. For example, a complementary sound treatment with a cavitation effect.
• • Characterized by a complementary sound treatment with adjuvant sound-induced cavitation effect.
• Characterized in that the killing of germs is based on a physical and / or chemical and / or bioactive action / reaction and / or on properties of carbon dioxide, but not causally / directly / directly on the effect of the adjuvant cavitation treatment, that is not (predominantly not) by a mechanical destruction of the germs by mechanical forces.
• Characterized by the fact that carbon dioxide in the physiology of the germ [affecting the life processes at the functional level of, for example, cells, cell associations, which are, for example, regulatory mechanisms that regulate the metabolic processes, cell division, etc., and / or control] such that this leads to cell death, the complementary treatment (eg sound) and / or its adjuvant effect (eg cavitation) but is not directly / directly involved in cell death.
• The cavitation-based potential germicidal effect of carbon dioxide in the treatment of germs and / or infections is characterized by the fact that carbon dioxide, which is used in the treatment in a carbon dioxide-containing medium, then germicidal effect, if with the help of a supporting acting cavitation effect on the Germs and / or on their biological structures such as cell walls, biofilms, other protective layers carbon dioxide in the cytoplasm / in the aqueous cytosol of germs accumulate in sufficient for a germicidal effect amount and the enriched carbon dioxide in the physiology of the germs can intervene such that this by a Acidification of the cytosol leads to cell death, but the cavitation is not directly involved in cell death, the germ killing is thus not by a Kavitationswirkung but by an effect of carbon dioxide.
• • The cavitation-based potential germicidal effect of carbon dioxide in the treatment of germs and / or infections is characterized by the fact that carbon dioxide, if a supportive, adjuvant Kavitationswirkung on the germs and / or their biological structures such as cell walls, biofilms, other protective layers for the conditions creates, that carbon dioxide accumulate in the cytoplasm of the germs and the enriched carbon dioxide in the physiology of the germs [the life processes concerning the functional level of, for example, cells, cell associations, such as regulating mechanisms that regulate and / or control the metabolic processes, cell division, etc.] can intervene in such a way that this leads to cell death, but the cavitation is not directly involved in cell death, the germ killing is therefore not done by a Kavitationswirkung but by an effect of carbon dioxide.
• Characterized by the fact that carbon dioxide can have a germicidal effect if carbon dioxide in a sufficiently large amount / in a sufficiently high concentration / in germs / in the cell interior of germs is introduced.
• Characterized by the fact that carbon dioxide can have a germicidal effect if the carbon dioxide introduced into the cell interior dissolves in the cytosol, dissociates and thus causes hyperacidity of the cytosol by lowering the pH. This hyperacidity through the physiological regulatory mechanisms of the germ - because of the high concentration can not be corrected and this then leads to cell death.
• Characterized by the fact that the effect of a cavitation treatment on germs and / or on their biological structures creates the conditions for carbon dioxide to reach the germs.
• Characterized by the fact that these prerequisites are changes, preferably mechanical changes, to biological structures that allow an external substance to penetrate, penetrate and pass / overcome these structures.
• • Characterized by the fact that the supporting effect of an adjuvant cavitation treatment, the carbon dioxide accumulate on germs, cell walls happen and is enriched in a sufficiently large amount in the cell interior / cytoplasm of the germs.
• • Characterized by the fact that the supporting and / or preparatory effect of adjuvant cavitation treatment allows carbon dioxide to pass through biological structures, even if the germs are originally protected from carbon dioxide by protective layers (biofilm, SCV and / or other coverings).
• Characterized in that carbon dioxide when used in a sufficiently high concentration in the medium (cavitation medium, mist, aerosol, etc.) is available, preferably as a cavitation effective component of a Kavitationsmediums, for example as "carbon dioxide".
• Characterized in that an originally not / only slightly germicidal substance, such as the preferred carbon dioxide, under certain conditions (as described) can be germicidal effect, therefore potentially germicidal effective called.
• Characterized in that by at least one complementary treatment with physical and / or chemical and / or biological / physiological (bioactive) and / or other action, for example, preferably by sound and sound-induced cavitation / cavitation effect conditions are created that include a suitable substance such as preferred carbon dioxide germicidal effect.
• • Characterized by a substance that can potentially kill germs and at the same time, by a completely different effect, creates the conditions for the substance to be germicidal, for example by the effect that the substance mechanically alters biologic structures of germs and thus the Provides conditions that the same substance can penetrate into the germs and there by at least one further reaction / effect germicidal effect, preferably the substance is carbon dioxide. As is the case with carbon dioxide, which as a cavitation-effective component of a cavitation medium by cavitation creates the conditions for the fact that the carbon dioxide can be germicidal effect as part of the cavitation medium by it can penetrate into the germs to unfold there its germicidal effect.
• • Characterized by a synergistic effect between carbon dioxide as potentially germicidal substance and carbon dioxide as cavitation-effective gas. Synergy effect between cavitation-effective carbon dioxide and potentially germicidal carbon dioxide. These are two different effects of the same gas, which can / have synergistic effects on simultaneous and / or timely application / effect.
• Characterized by a substance, preferably carbon dioxide, which has at least two different effects of the same substance, for example the effect of cavitation and the germicidal effect, the substance itself has a synergistic effect. The substance, preferably carbon dioxide, is synergistically effective, especially if the substance, preferably carbon dioxide, is a cavitation-effective and potentially germicidal component of a cavitation medium. This is especially true in a cavitation treatment in the presence of this substance, preferably carbon dioxide.
• Characterized by a Kavitationsmedium that by the same substance (preferably this is carbon dioxide) as part of the Kavitationsmediums at least two different Funktio has and / or effects attributable to the different modes of action of that one substance and that these modes of action complement each other and, together, lead to a synergistic effect of the same substance. With carbon dioxide as a cavitation-effective component of a cavitation medium, cavitation can be induced by sound in the cavitation medium (this is a mode of action of carbon dioxide), this cavitation having carbon dioxide involved in the treatment of germs and / or their biological structures has, inter alia, a mechanical effect on the structures and leads to changes in the structures through which the carbon dioxide can get into and into the germs to be enriched. In the cell interior of the germs, carbon dioxide dissolves in the cell fluid and dissociates when the pH is lowered (second mode of action). The pH reduction has germicidal effect (mode of action of carbon dioxide) and leads to cell death of the germs. The accumulation of carbon dioxide and the killing of germs would not be possible without the effect of cavitation, in which carbon dioxide plays a decisive role. The interaction of different modes of action of carbon dioxide has led to a synergistic effect / acts synergistically.
• • Characterized by a synergistic effect of a cavitation treatment with a carbon dioxide-containing cavitation medium.
• Characterized by a cavitation medium containing at least one synergistically active substance as constituent, preferably the substance is carbon dioxide. Synergistically effective because the substance has at least two different effects, and in that these effects interact, it also has a synergistic effect.
• • Characterized by a cavitation medium with internal, own synergy effect, in that a substance is a cavitation-effective component of the cavitation medium and at the same time has a potential germicidal effect and neither cavitation nor substance alone is germicidal / would be effective.
• • Characterized by a cavitation medium with new properties, features, applications. For example, with potentially germicidal effect. For example, with synergy effect.
• • Characterized by an application of carbon dioxide, which takes place at the same time and / or in time for cavitation treatment.
• Characterized preferably by the use of a cavitation medium in which carbon dioxide is a cavitation-effective component and is a potentially germicidal and / or additionally therapeutically physiologically active substance.
• • Characterized by the fact that the treatment is subaqual, according to the picture 1 and / or the too 1 belonging and / or related description. And / or in a based on the subaqualen treatment and the arrangement described thereby underlying, but modified form, can be done.
• The cavitation medium is characterized by further possible therapeutic effects, for example physiological effects of the gas dissolved therein (eg carbon dioxide).
• Characterized in that the carbon dioxide strongly enriched medium for the treatment of problematic germs and problematic infections is preferably identical to the cavitation medium and preferably consists of water and / or an aqueous solution in which carbon dioxide is dissolved in high to very high concentration, preferably in one Concentration 1500 mg / l, even over 1500 mg / l.
• • Characterized that the cavitation effect on the problematic germs / problem infections by the treatment in the cavitation medium and the treatment of the germs with potentially germicidal carbon dioxide occur simultaneously, simultaneously in the same medium.
• • characterized in that the cavitation medium is a medium in which the dissolved carbon dioxide in the cavitation, as a cavitation effective component, is involved and at the same time contained as a germicidal substance in cavitation medium, the carbon dioxide in the cavitation medium has at least two different effects, the cavitation effect and that of the germicidal substance and both effects complement each other synergistically.
• • Characterized that the cavitation medium has at least two different effects due to the carbon dioxide dissolved therein, which together have a synergistic effect.
• Characterized in that the sonication from the cavitation medium induces a supporting cavitation in such a way that the cavitation / cavitation effect acts on the biological structures of the germs, preferably on cell walls, biofilms and other protective layers, preferably mechanically, to make them externally supplied substances How to make the carbon dioxide permeable with the aim of enriching carbon dioxide inside the cell, thereby causing cell death.

advantages

Important Advantages were in / by the solution of the problem called (for example, in terms of resistance of the germs, Protective layers, side effects, etc.).

Other important benefits are safe, safe use. The treatment can be with other treatments are combined. A gentle / tissue-sparing treatment, for example in contrast to a risky ultrasound debridement. Carbon dioxide can have multiple effects that can be used therapeutically at the same time. Carbon dioxide can penetrate into the smallest cracks, pores, etc., in order to be effective there. The treatment is easy to perform, inexpensive, safe to handle, without side effects.

pictures

1 , Subaquale arrangement for a treatment of the object in a "water bath", the object is immersed in and covered by the cavitation medium. Arrangement of a subaquional cavitation treatment of a leg (biological system) in a water bath at the same time as carbon dioxide treatment. The leg is covered / enveloped by the cavitation medium. Carbon dioxide is part of the cavitation medium. In this presentation, both the leg and the sound applicator dive into the cavitation medium. The cavitation is preferably / predominantly in the liquid layer between the leg and the sound-emitting surface of the sound applicator. A subaquale treatment would also be possible if the sound applicator did not dive into the cavitation medium, but would touch it, for example, only at one contact surface.

2 , Represents a possible arrangement in which the cavitation treatment and the application of carbon dioxide take place in a timely manner. The cavitation treatment of the biological system can also take place in the chamber and / or outside the chamber. Subsequently, the thus treated biological system is subjected to an application with carbon dioxide. In the example, inside the chamber under pressure in a concentrated carbon dioxide atmosphere.

In a sound and / or cavitation treatment of biological systems, as well as in germs and / or their biological structures, the sound characteristic has an effect on the cavitation and / or on depth / surface effect, including the transport of substances, the absorption of substances / of biological systems, etc. Besides the frequency and the sound intensity, further sound characteristics also play a role. For example, whether the sound is emitted in continuous or in pulsed form. The burst of sound (eg, sinusoidal, triangular, rectangular, or other shape), the way in which bursts of sound are delivered, the signal / waveform (eg, symmetric, asymmetrical), etc., which amplifies, for example, the compression or tension phases / can be reduced. A multitude of possibilities for influencing, controlling and optimizing the cavitation and / or the effect of sound on the sound characteristic are known and described. Design options of Schallapplikators, the sound generator and the sound characteristic according to the state of technology, representative of, for example, in the EP 0 330 636 B1 . EP 0 442 278 B1 . EP 0 595 783 . EP 0335851 . WO 98/07470 and many others are described and can also be applied here. Supplementary / extended description of sound applicator, sound characteristics, etc. also in DE 10 2004 060 071 . DE 10 2006 027 789 . DE 10 2004 004 415 ,

3 Example for understanding a different sound output by the sound applicator. A = continuous sound. B = delivery in rectangular shaped sound packets (sound bursts) with a time interval between two sound packets.

Example for understanding the schematic representation of a sinusoidal sound packet (sound burst) in 3 of the DE 102 33 293 ,

Example for understanding a single sawtooth-shaped sound pulse (single sound burst) with unbalanced signal / waveform. Unsymmetrical, sawtooth waveform / waveform of a single sonic pulse (single sonic burst). In the schematic representation of the negative pressure component is greater than the positive pressure component in 2 of the DE 102 33 293 ,

Treatment, application, procedure, method, Manufacture, use

• • Application and / or use of Carbon dioxide as a potentially germicidal substance in the Treatment of germs, preferably in the treatment of problematic germs, more preferred in the medical treatment of infections, even more preferred in the medical treatment of problematic infections in humans and / or animals.
• • Application and / or use of a cavitation medium with carbon dioxide as a cavitation-effective component and as potentially germicidal effective substance in the treatment of germs, preferably in the Treatment of problematic germs, more preferred in the medical Treatment of infections, even more preferred in the medical Treatment of problematic infections in humans and / or animals. Prefers is as Kavitationsmedium the described "carbonic acid water".
• Use and / or use of carbon dioxide and / or a carbon dioxide-containing medium, preferably a cavitation medium, for example the said "carbonic acid water", for the treatment of germs / problem germs and / or infections / problem infections in conjunction with a complementary acoustic treatment with cavitation effect.
• • Application of a potentially germicidal acting cavitation medium in the treatment of germs for the purpose their killing.
• • Method / method of killing germs / microorganisms with a potentially germicidal cavitation medium and / or a potentially germicidal substance.
• • Method / method of killing germs / microorganisms with carbon dioxide and a complementary sound treatment, preferably with cavitation effect.
• • Method and / or method of killing of germs with a potentially germicidal effect Substance, preferably carbon dioxide, at / by (with the aid of from) physical and / or chemical forces / energy / action, preferred by sound-induced cavitation at low to medium sound intensity, by the action of these forces / effects / energies on germs and / or their biological structures (for example protective layers) Requirements (for example and / or preferably by structural change of biological structures of the germs, e.g. B .. loosening, destruction, Increase in permeability, etc.) (therefore potentially), so that the substance to be killed Germs enter, penetrate into them, in the cell interior of the germs accumulation can lead to cell death, for example by a physiological and / or chemical and / or physical Reaction / mechanism / effect. The germicidal effect of the method and / or the method is not / predominantly not on the cavitation effect, so not predominantly not by mechanical destruction of the germs like this, for example would be the case for transient cavitation.
• • Treatment and / or method of killing of germs / microorganisms with a potentially germicidal acting substance, preferably of carbon dioxide, in which by (with Help of) physical and / or chemical forces / energy / effect, preferred by sound-induced cavitation at low to medium Sound intensity, by the action of these forces / effects / energies on germs and / or on their biological structures (for example Protective layers) Requirements (for example and / or preferred by structural change of biological structures of the Germs, z. B .. loosening, destruction, increase the permeability, etc.) are created so that the Get substance to the killing germs, penetrate into this, can accumulate in the cell interior of the germs, thereby causing cell death to lead, for example by a physiological and / or chemical and / or physical reaction / mechanism / action. The germicidal effect of the method and / or the method is not / mostly not based on the cavitation effect, So not / mostly not by mechanical destruction the germs like this, for example, in transient cavitation (z. As ultrasonic debridement) would be the case.
• Production and / or use / application of a cavitation medium, prefers the "carbonic acid water" to Killing of germs in conjunction with a complementary one Sound treatment with cavitation effect
• • Use / application of a suitable substance, preferred of carbon dioxide to produce a potentially germicidal acting Kavitationsmediums (as described above), preferably with Carbon dioxide as a cavitation-effective component and / or as germicidal acting substance.
• • Use / application of a suitable substance, preferred of carbon dioxide, as potentially germicidal Fabric in conjunction with at least one other complementary Treatment, preferably sound, with physical and / or chemical and / or bioactive action, preferably with cavitation effect, for Treatment of germs, especially problematic germs and / or of their biological structures.
• • Cavitation medium and / or use / application of a Cavitation medium with potentially germicidal effect (as described above) to kill germs, better Problem germs, for example, preferably in the treatment of infections in humans and / or animals, more preferably for the treatment of Problem infections.
• Cavitation medium and / or use of a cavitation medium, preferably a cavitation medium / cavitation medium with potentially germicidal Effect (as described above) for the enrichment of at least one potentially germicidal substance, preferably carbon dioxide, in the cell interior of germs / microorganisms.
• • Cavitation medium and / or use / application of a Cavitation medium, preferably a Kavitationsmediums with potentially germicidal effect (as described above) on germs and / or their biological structures, for example by cavitation to their permeability / permeability for externally supplied substances / substances.
• Use / application / use of the cavitation effect and / or its (mechanical) effect, in order to make a substance that does not per se or only slight toxicity (preferably carbon dioxide) a germicidal substance, by cavitation and / or its effect Substance accumulate at / in the germ and can cause an effect that kills germs, not germicidal / only slightly effective by the Kavitationswirkung.
• • Use / application / use of cavitation and / or their effect for introducing / introducing / enriching at least a potentially germicidal substance, preferably of carbon dioxide, in the cell interior of germs and / or in their biological structures.
• • Simultaneous and / or timely use / application of carbon dioxide (as a potentially germicidal Gas) and / or with a cavitation treatment in the treatment of Germs, preferably from infections in humans and / or animals and / or of biological structures of the germs.
• • Cavitation medium and / or use / application / use the same, in addition to its action / function / use as Kavitationsmedium at the same time (by at least one suitable and / or cavitation effective Gas / suitable substance, preferably carbon dioxide) at least one bioactive, for example, a physiological and / or a germicidal Has effect, especially if this cavitation medium in combination with sound for a cavitation treatment is applied and / or the sound by means of Kavitationsmediums to the biological System is docked.
• Application / Use of carbon dioxide as potentially germicidal gas and / or of a potentially germicidal cavitation medium in an arrangement for the treatment of biological systems and / or germs and / or their biological structures, as exemplified in the figure 1 and or 2 represented and / or described.

additions

The Combination of at least two potentially germicidal acting substances may be possible, for example carbon dioxide with oligodynamically active substances / compounds, eg. Metals / metal ions / alloys / metal compounds. z. Silver / silver ions / nanocrystalline silver, other metals / metal ions / metal compounds z. As platinum, gold, copper, manganese, etc. Also other substances / active ingredients / pharmaceutical Active ingredients can be added to the cavitation agent and / or before being applied after a cavitation treatment. Naturally You can also use other substances than carbon dioxide in the the cavitation effect of permeable protective layers penetrate, for example substances that have been added to the cavitation medium.

described were "open" infections, ie infections, which are accessible from the outside. The treatment of germs, cells, cell aggregates, etc. potentially germicidal acting substances, eg. As with carbon dioxide, in principle also in places that are not openly accessible (eg organs) be possible, for example, if this with a potentially germicidal substance enriched / filled can be, for. B. in a cavity.

The formation of the gas bubbles and the cavitation preferably take place on and / or near the object surface (eg of the biological system). The cavitation medium is used for coupling the sound to the biological system, wherein the germs / microorganisms, for example as a germ / bacteria suspension, can be located directly in the cavitation medium. More commonly, the cavitation medium will contact the germs / microorganisms and / or their biological structures at an interface, for example, in subaqually treating a skin infection similar to that shown in FIG 1 ,

The effectiveness of carbon dioxide as a germicidal substance requires the effect of cavitation on the biological structures of germs. In the simple case these barriers / biological structures are cell walls / membranes, in more difficult cases biofilms and / or other protective layers. The effects of cavitation on biological systems of germs are, for example, increasing the permeability of membranes, cell walls, etc., but also increasing the permeability to substances / substances of protective layers / barriers (as described elsewhere) such that carbon dioxide, for example, biological structures better, ie can overcome quickly and in a sufficiently high amount / concentration. DE 10 2004 004 415 describes some effects of cavitation and / or sound in the form of depth / surface effects.

Further comments or definitions

sound in the description may monofrequent sound (a frequency) and / or duofrequent (two different frequencies) and / or multifrequent Sound (with at least two different sound frequencies) mean. For duo and / or multifrequent sound the different frequencies simultaneously and / or not simultaneously (For example, intermittently and / or in another Form) to the medium, e.g. B. to the cavitation medium, by at least one Sound source (eg at least one sound applicator) be delivered.

The sound characteristic can have a special influence on the cavitation as well as on the effect (depth / surface effect) of the sound / cavitation (for example with regard to Fre quency, intensity, etc., including, for example, pulsed sound, continuous sound, etc., such as the signal / waveform, etc.). Sound emission according to the technical state and according to the optimization of a certain effect, for example optimization with regard to cavitation. Sound in the description initially means sound of any sound intensity [in accordance with conventional terms such as SATA, etc.] (eg, from 0.001 watts / cm ² to 500 watts / cm ² , 0.001 watts / cm ² to 20 watts / cm ² , preferably 0.001 watt / cm ² to 10 watt / cm ^2, more preferably 0.001 watt / cm ² to 5 watt / cm ² , more preferably 0.001 watt / cm ² to 2 watt / cm ² ), any sound pressure (eg from 0, 05 Pa to over 500000 kPa range, preferably 0.5 Pa to 500 kPa, further preferred sound pressure ranges 0.5 Pa to 50 kPa, 50 kPa to 2100 kPa, 100 kPa to 300 kPa, 300 kPa to 500 kPa), any sound amplitude. Preferably acoustic low to medium intensity (1 mW / cm ² -10W / cm ²⁾ and / or higher, more preferably of 0.001 watts / cm ² to 5 watts / cm ² more preferably of 0.001 watts / cm ² to 2 watts / cm ² . The distance of the sound-emitting surface to the object (surface of the biological system may initially be arbitrary (0.0001 mm-100 m) Preferably below 1 mm to 100 cm, more preferably below 1 mm to 20 cm, even more preferably from below 1 mm 5 cm, most preferably less than 1 mm (eg) 0.01 mm to 2 cm.

The coupling of the sound to the biological system should preferably be carried out by the cavitation medium, preferably subaqual as in 1 and / or in that the cavitation medium contacts the biological system and / or the object surface. Between the sound-emitting surface of the sound applicator and the cavitation medium, at least one further sound-conducting layer can be located and / or attached, wherein for example the sound is transmitted from the sound applicator to the further sound-conducting layer and from there to the cavitation medium.

any suitable Schallapplikator, suitable for the requirements of a Schallapplikator to fulfill, which of the previously cavitation-based potentially germicidal effect of carbon dioxide "described Treatment to be placed on a sound applicator [sound intensity, sound characteristics etc.].

Any suitable gas that can potentially kill germs under the conditions described. Advantageous if the gas dissolves in water, in aqueous solutions and / or in another suitable liquid, other suitable medium in a sufficiently high concentration, for example, polar gases in polar liquids. Other examples of gases are in the DE 102004004415 called, but must not be suitable gases.

The Cavitation preferably takes place in a liquid cavitation medium, but also other common, known cavitation media (For example, steam, fog, aerosol, etc.) are possible. In gas cavitation cavitation occurs by stimulation of, z. B. in cavitation medium, gas bubbles to (oscillating) Gas bubble vibrations up to resonance vibrations of the gas bubbles. Next, the formation of gas bubbles from the Kavitationsmedium by a sound effect on the cavitation medium during the treatment (by transition from dissolved, z. B. molecular dissolved gas in the gas bubble state) possible be, and these gas bubbles are excited to vibrate. education of gas bubbles in situ: the gas bubbles do not have to start be present in the cavitation medium, but they can also be formed during the treatment, the cavitation medium serves as a gas bubble source. Dissolved in the cavitation medium Gas is generated by the sound pressure under the influence of sound transferred to the cavitation medium in the blistered state (gas bubble formation).

A Cavitation almost only has an effect on a biological system and / or its surface when cavitation is near the surface and / or on the surface. This can be achieved For example, if the distance of the sound-emitting surface can be kept low to the object surface. there the gas concentration in the medium should be high and high during the treatment repeatedly (in situ) can form new gas bubbles.

cavitation, preferably sound-induced cavitation, more preferably by ultrasound induced cavitation, more preferably by low frequency ultrasound induced cavitation. Surface and / or depth effect caused by cavitation and / or by sound, preferably low-frequency ultrasound causes / causes.

A Cavitation / cavitation reaction can also without proper Kavitationsmedium take place, for example, if an object surface (z. Skin as the surface of a biological system) with gas bubbles, which adhere to the surface / in pores, etc., enriched is.

Cavitation can also take place without actual cavitation medium. For example, if sufficient gas bubbles are available for cavitation in the boundary layer between the coupling medium and the object surface and these can also be excited to oscillate. For example, in an enrichment of an object surface (surface of a biological Sys tems, z. Skin, wound, etc.) with at least one gas, e.g. With carbon dioxide. By coupling the sound to the surface with a coupling medium (eg liquid) in which the gas is only slightly / not soluble, the gas can be held on the object surface without migrating into the coupling medium. One possibility for enriching the surface of the object (eg skin) with gas / gas bubbles may be that the retention / adhesion (eg by adhesion) of the gas at the surface is improved, for example by using the polarity in the case of polar Gases like carbon dioxide. Another possibility may be that the object surface is first wetted with a polar liquid layer and then exposed to a gas atmosphere (eg carbon dioxide), preferably under pressure (analogously to US Pat 2 ). Another possibility may be that, for example by using at least one further substance / active substance (eg urea, containing urea as an example), which is applied to the surface, moisture (eg water) is supplied to the surface and this leads to a chemical reaction / decomposition in which at least one gas is released, for example the hydrolysis of urea. In aqueous environment urea decomposes by hydrolysis into carbon dioxide and ammonia. Gases that are cavitation-active and potentially capable of destroying germs.

Cavitation as well as sound treatment have on the object to be treated / biological system depth as well as surface effect ( DE 10 2004 004 415 ).

Further areas of application and / or use

Application / Scope / Scope cavitation-based potentially germicidal Effect of carbon dioxide can be all areas at which germs have to be killed, that is especially true where problem germs occur and / or other methods / methods Seed treatment fail and / or can not be applied. This also applies in areas with biofilm problems.

Application / Scope / Scope a cavitation medium, the carbon dioxide as cavitation effective Component and / or as potentially germicidal Gas as a component can contain all areas in which germs are to be killed, that is especially true where problem germs occur and / or other procedures / methods fail for germ treatment and / or can not be applied. This also applies in areas with biofilm problems.

at the therapeutic / medical treatment of infections with Problem germs in humans and / or animals, for example, if the germs are resistant to active substances (eg against Antibiotics and / or against other agents) have formed and / or the germs protected by protective layers against drugs are etc. and the active ingredients fail (almost ineffective / ineffective stay).

at the therapeutic / medical treatment of infections with Germination in humans and / or animals, for example, even if other treatment methods and / or products / devices fail and / or can not be used (eg because of strong Side effects, etc.) and / or should not be used. The also relates to applications in which high energy, eg. Legs high sound energy (eg power sound) to unwanted Damage to biological systems can lead, and / or a treatment (eg, an ultrasound debridement, a surgical Debridement, etc.) because of a high risk potential for Patients and / or users only by trained personnel is to perform. Therefore a treatment with low / medium Sound energy / sound intensity is to be preferred. A treatment that is also handled by an extended group of people can be. This also applies to applications / treatments to that not to be performed everywhere (eg ultrasonic debridement), because, for example, the necessary devices are missing, because For example, home treatment performed on the patient should be etc ..

at therapeutic / medical treatment for the prophylaxis of Infections with germs in humans and / or animals.

at non-therapeutic / non-medical treatment in humans and / or animals for disinfection, for example in the field of hygiene, Cosmetics, etc., biofilm problems To avoid and / or combat germination in the technical field, water engineering, etc., too in biofilm problems.

Applications / Use the described potentially germicidal gas and / or the cavitation medium for therapeutic / medical Treatment of external (from the outside to be treated) infections / problem infections by germs / problem germs in humans and / or animals. For example, in infections of Wounds, skin, bones (osteitis / osteomyelitis), nail bed infections and other medical treatment applications and / or for infection prophylaxis.

Therapeutic / medical treatment infections that are not treated externally, such as organs, such as organs that form a cavity and could be filled with a cavitation medium and / or a suitable gas. Ultrasonic application from the outside and / or from the inside possible.

Therapeutic / medical and / or scientific treatment of cells, cell aggregates, Tissue.

Use / Application in the non-therapeutic / non-medical field of treatment of humans / animals, z. B. in the field of hygiene / body culture (eg athlete's foot, surgical hand disinfection, Decontamination, cleaning, etc.) and / or in the field of cosmetics, other Applications. Also for prophylaxis. Application generally in Area "Life Science". Cleaning, disinfection.

Application / Use in technical / industrial / scientific fields where a Contamination with germs should be prevented and / or eliminated. For example, with problems with biofilms, biocorrosion, biofouling etc., for example medical / medical technology, medical devices / devices etc., food industry, water management, general industry, etc. where keeping clean, producing germ-free / germ-free conditions necessary is, etc. Household appliances, cleaning equipment / devices etc .. Application / Use as material / object gentle method in Areas where normally (transient) cavitation for cleaning / disinfection is / can be used.

QUOTES INCLUDE IN THE DESCRIPTION

This list The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

• - DE 10233293 [0010, 0012, 0047, 0049, 0059, 0067, 0083, 0084]
• - DE 102004004415 [0012, 0049, 0059, 0081, 0088, 0093, 0099]
• - EP 0335851 [0052, 0081]
• - EP 0595783 [0052, 0081]
• EP 0330636 B1 [0081]
• EP 0442278 B1 [0081]
• WO 98/07470 [0081]
• - DE 102004060071 [0081]
• - DE 102006027789 [0081]

Cited non-patent literature

• - Peschen M. et. al, "Low-frequency Ultrasound Treatment of Chronic Leg Ulcers in Good Patient Therapy", Acta Derm Venereol 1997; 77: 311-314 [0050]
• Weichenthal et al. "Low-frequency ultrasound treatment of chronic venous ulcers" Wound Rep Reg 1997; 5: 18-22 [0050]
• - Ottstadt et al. "Does Subaqual Low Frequency Ultrasound Heal Arterial Venous Ulcera Cruris?", Vasomed 1998; 10: 24-32 [0050]
• Lindner et al. "Results and Experience with Performance Sound in the context of Complex Treatment of Diabetic Gangrene", Z. Klin. Med. 42 (1987); Issue 6: 503-506 [0053]
• - "Killing of microorganisms by compressed carbon dioxide". Dissertation (2005) to obtain the degree Doctor of Engineering at the Faculty of Mechanical Engineering of the Ruhr University Bochum presented by Reiner Daiminger from Burghausen [0060]

Claims (19)

The cavitation-based potential germicidal effect of carbon dioxide in the treatment of problematic germs and / or problematic infections with a medium strongly enriched with carbon dioxide is characterized in that due to a complementary in a cavitation medium sound treatment of the germs with Kavitationswirkung on the germs, the carbon dioxide in a for a germicidal effect sufficiently high concentration in the cell interior of the germs can accumulate in order to trigger a reaction in the aqueous environment of the cytoplasm (cytosol), which leads to a strong, no longer controllable by the germ hyperacidity of the cytosol and thus to cell death. Characterized in that with carbon dioxide highly enriched medium of claim 1 for the treatment of problem germs and problematic infections are preferably identical to the Kavitationsmedium from claim 1 and preferably from water and / or from an aqueous Solution exists in the carbon dioxide in high to very high Concentration is dissolved, preferably in one concentration 1500 mg / l, even over 1500 mg / l. Characterized in that from claim 1 and 2 shows that the cavitation effect on the problem germs / problem infections by the treatment in the cavitation medium and the treatment of the Germs with potentially germicidal carbon dioxide simultaneously, simultaneously in the same medium. Characterized in that the Kavitationsmedium from claim 1 together with claims 2 and 3 a Cavitation medium results in which the dissolved therein Carbon dioxide at the cavitation, as a cavitation-effective component, is involved and at the same time as germicidal Substance is contained in Kavitationsmedium, the carbon dioxide in cavitation medium has at least two different effects, the cavitation effect and those of the germicidal substance and both effects complement each other synergistically. Carbon dioxide as synergistic effective component of a cavitation medium. Characterized in that the Kavitationsmedium from claim 4, 5 by the carbon dioxide dissolved therein has at least two different effects, which together one Synergy effect. Cavitation medium with internal, own synergy effect, carbon dioxide is a cavitation-effective component of the cavitation medium is and at the same time potentially germicidal and neither cavitation nor carbon dioxide alone destroys germs are / would be effective. Characterized in that the sound treatment from claim 1 in Kavitationsmedium from the claims 1-5 induces a supporting cavitation such that the cavitation / cavitation effect on the biological Structures of the germs, preferably on cell walls, biofilms and other protective layers, acts, preferably acts mechanically, to them for externally supplied substances such as carbon dioxide permeable with the goal of carbon dioxide inside the cell enriched, thereby causing cell death. Characterized in that according to claim 1 and 6 the carbon dioxide by the Kavitationswirkung in for Enriched a germicidal effect of sufficient amount in the cell interior and dissolves in the aqueous environment of the cytosol, dissociated and hyperacidity of the cytosol caused by a lowering of the pH and to the death of the germs leads, because these are not the hyperacidity can regulate / correct more. The germ killing due to properties and reactions of carbon dioxide, which intervenes in the physiology of the germs, but not as direct, immediate consequence of a cavitation effect. The cavitation-based potentially germicidal Effect of carbon dioxide on germs of claim 1 is still characterized in that these processes and also the germicidal effect of carbon dioxide at low to medium sound intensity occur and / or that the Treatment at low to medium sound intensity can be done. The cavitation effect is insufficient to Killing germs of medically relevant extent. Arrangement for the subaqual treatment of infections / problem infections with a cavitation medium, the carbon dioxide as potentially germicidal contains active substance. Characterized in that the germs in the claims Problem germs are those against the action of active ingredients and / or are protected by pharmaceutical agents, preferably by resistance, more preferably by protective layers thereof prefers biofilms, small colony variants, other protective layers made of predominantly organic material, with an external substance the germs can not reach enough to germicidal not to carbon dioxide. Characterized in that the germs in the claims Problem germs are due to active ingredients because of side effects and / or for other reasons. Characterized in that by the un Supplementary and / or preparatory effect of adjuvant cavitation treatment according to claim 1, 6, the carbon dioxide can pass through biological structures, even if the germs are protected by protective layers (biofilm, SCV and / or other deposits) originally from carbon dioxide. According to claim 1, the cavitation-based is potentially germicidal effect of carbon dioxide, that by having at least one complementary treatment with physical and / or chemical and / or biological / physiological (bioactive) and / or other action, for example preferably by sound and sound-induced cavitation / cavitation effect prerequisites be created, which is a suitable substance such as the preferred one Allow carbon dioxide to germicidal effect. Use and / or use of carbon dioxide as potentially germicidal substance during treatment of germs, preferred in the treatment of problematic germs, more preferred in the medical treatment of infections, even more preferred in the medical treatment of problematic infections in humans and / or animals. Use and / or use of a cavitation medium with carbon dioxide as a cavitation-effective component and as potential Germicidal substance in the treatment of germs, preferred in the treatment of problematic germs. Preferred is as Cavitation medium the described "carbonic acid water". Use and / or use of carbon dioxide and / or a carbon dioxide-containing medium, preferably a cavitation medium, for example, the said "carbonic acid water", for the treatment of germs / problem germs and / or infections / problem infections in conjunction with a complementary sound treatment with Cavitation. Application of a potentially germicidal Cavitation medium in the treatment of germs for the purpose of their Killing. Method / method for killing germs / microorganisms with a potentially germ-killing cavitation medium and / or a potentially germicidal substance. Method / method for killing germs / microorganisms with carbon dioxide and a complementary sound treatment, preferably with cavitation effect.