JP2011161222A - Optical wound treatment device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a device capable of further accelerating healing of a wound, in an optical treatment device utilizing the cell activation mechanism using light irradiation. <P>SOLUTION: This optical wound treatment device includes: a first healing accelerating means for irradiating light of a predetermined wavelength band to an object part of a living body; and a second healing accelerating means disposed in the object part. In the optical wound treatment device, the second healing accelerating means is a covering material covering the object part and having permeability to the light radiated from the first healing accelerating means or a conductive member connected to a power supply to apply electric stimulation to the object part. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to an optical wound treatment apparatus. Specifically, the present invention relates to an optical wound treatment apparatus that promotes healing by irradiating light to a wound portion of a living body.

  In healing burns, pressure ulcers, diabetic ulcers, varicose ulcers, surgical wounds, and other injuries (hereinafter collectively referred to as “wounds”), removal of necrotic tissue and bacteria, moderate moist environment Maintenance and prevention of infection and contamination are necessary. Conventionally, a method using an ointment gauze or the like, a method of sealing a wound with a liquid-impermeable bandage, or the like has been applied to the treatment of wounds.

  In recent years, various types of phototherapy devices have been developed to promote wound healing and relieve chronic pain such as muscular joints by irradiating a living body with a low-power laser beam of about 10 to 100 mW, which is also used in actual clinical practice. It is coming.

  Patent Document 1 discloses a light wave wound treatment device intended to promote a surgical wound treatment using a semiconductor laser element or a light emitting diode element. This light wave wound treatment device has no therapeutic tendency even by drug administration or surgical methods, and has a therapeutic promoting effect on all wounds including intractable ulcers that cannot be applied to the hands at all. Has been.

  Patent Document 2 discloses a laser treatment apparatus in which laser beams output from a plurality of semiconductor laser elements are mixed and emitted as one output. This laser treatment apparatus can easily form a laser light irradiation range suitable for a treatment affected area, and can treat a relatively wide range of affected areas at a time.

  Such an action of the laser beam on the living body is explained by activation of the cells by appropriate energy irradiation. Cell activation by light irradiation is considered to be based on the following mechanism. Mitochondrial activity is activated when flavin dehydrogenase, cytochrome, cytochrome oxidase, etc., which are respiratory chain compounds in mitochondria, absorb light energy, increase NAD, increase metabolic state, increase ATP, and release to cytoplasm And changes the redox state of mitochondria and cytoplasm. Through light, a series of phenomena occur inside the cell, affecting calcium ions that flow inside and outside the cell membrane, amplifying the signal, affecting the nucleus, and promoting RNA and DNA synthesis, It affects differentiation (see Non-Patent Documents 1 and 2).

  As a phototherapy device using the same mechanism, a device (Patent Document 3) that measures cellular activity by light irradiation, stimulates microcirculation in the body to reduce soft tissue pain, reduces inflammation, and fiber by light irradiation. An apparatus (Patent Document 4) for activating wrinkle cells and improving the function to remove wrinkles has been proposed.

JP 60-114273 A JP-A-5-161718 JP 2008-188258 A JP 2006-25808 A

"Photobiology of low-power laser effects." Health Physics, 1989, Vol.56, No.5, p.691-704 "Primary and secondary mechanisms of action of visible to near-IR radiation on cells." Journal of Photochemistry and Photobiology B, Biology. 1999, Vol.49, No.1, p.1-17

  The conventional phototherapy devices disclosed in Patent Documents 1 and 2 are not yet sufficient for medical staff and patients from the viewpoint of healing performance, ease of management, treatment costs, and the like.

  Therefore, the main object of the present invention is to provide an apparatus capable of further promoting healing of a wound in an optical wound treatment apparatus using a mechanism of cell activation by light irradiation.

In order to solve the above problems, the present invention provides an optical wound comprising: first healing promoting means for irradiating a target site of a living body with light of a predetermined wavelength band; and second healing promoting means disposed on the target site. A therapeutic device is provided.
In this optical wound treatment apparatus, the second healing promotion means covers the target site, and is connected to a covering material that is transmissive to the light irradiated from the first healing promotion means, or a power source, The conductive member is used to apply electrical stimulation to the target site.
In the case where the second healing promoting means is configured as a covering material, the covering material includes the target site in an airtight manner, and is formed in a shape that can be connected to a negative pressure source. It is preferable that it is formed into a gel or film that is in close contact.

  According to the present invention, there is provided an apparatus capable of further promoting wound healing in a phototherapy apparatus utilizing a cell activation mechanism or the like by light irradiation.

It is a schematic diagram for demonstrating suitable embodiment of the 2nd healing promotion means comprised as a negative pressure closure cover. It is a schematic diagram for demonstrating the frame-shaped member 16 arrange | positioned at the negative pressure closure cover 1. FIG. FIG. 3 is a drawing-substituting graph showing temporal changes in the size of wounds in healthy rats (Example 1). FIG. 3 is a drawing-substituting graph showing changes over time in the size of wounds in immunosuppressed model rats (Example 1). It is a drawing substitute graph which shows the time-dependent change of the size of the wound in a healthy mouse (Example 2). 10 is a drawing-substituting graph showing changes over time in the size of a wound in a diabetes model mouse (Example 2). It is a drawing substitute graph which shows a time-dependent change of the magnitude | size of the wound in a healthy mouse | mouth (Example 3). It is a figure-substituting graph which shows the number of the new blood vessels observed in the wound part of the healthy mouse (Example 3).

  DESCRIPTION OF EXEMPLARY EMBODIMENTS Hereinafter, preferred embodiments for carrying out the invention will be described with reference to the drawings. In addition, embodiment described below shows an example of typical embodiment of this invention, and, thereby, the range of this invention is not interpreted narrowly.

1. 1st healing promotion means The optical wound treatment apparatus which concerns on this invention is the 1st healing promotion means which irradiates the target site | part of the biological body with the light of a predetermined wavelength band, The 2nd healing promotion means distribute | arranged to a target site, . Here, the control site means a living body site where a wound exists, and is hereinafter also referred to as “wound part”.

(1) Light source As a light source of the first healing promoting means, a combustion light source, an incandescent bulb, a discharge lamp, a chemical lamp, a laser, electroluminescence, nanosilicon, or the like is used.
Of these, examples of the combustion light source include an oil lamp, a candle, a gas lamp, and a chemical flash lamp.
Incandescent light bulbs are roughly classified into low-pressure discharge lamps and high-pressure discharge lamps. Examples of the low-pressure discharge lamp include an arc discharge type such as a fluorescent lamp, a sterilization lamp and a low-pressure sodium lamp, a glow discharge type such as a fluorescent sign and a neon sign, and an electrodeless discharge type such as a fluorescent lamp. Examples of the high pressure discharge lamp include a carbon arc lamp, a high pressure mercury lamp, a metal halide lamp, an ultrahigh pressure mercury lamp, a xenon lamp, a krypton lamp, a sodium lamp, and an electrodeless rare gas lamp.
Examples of electroluminescence include EL in a narrow sense such as inorganic EL and organic EL, and light emitting diode (LED).
Examples of the laser include a solid-state laser, a semiconductor laser, a dye laser, and a gas laser.

  The light source is preferably electroluminescence and laser, and electroluminescence is particularly preferred. Further, the electroluminescence is preferably LED or organic EL.

  The form of the light source is not particularly limited, but is preferably a size and shape that does not excessively restrict the movement of the patient even during optical wound treatment. For example, a lightweight, small, and portable device that can be freely moved by the patient in a state of being fixed on the wound portion or a covering material described later is preferable.

(2) Optical path The light from the light source can be directly or indirectly applied to the wounded part of the living body. The optical path from the light source to the wound part is not particularly limited. For example, light from a combustion light source, an incandescent bulb, a discharge lamp, a chemical lamp, electroluminescence, or nanosilicon can be directly applied to the wound part. In addition, when the light source is electroluminescence, an LED or the like can be placed in contact with the wound portion to directly irradiate light. In particular, when the light source is an organic EL, the organic EL can be wound around the wound portion and directly irradiated with light.
Moreover, the light from these light sources and lasers may be guided to the wound part by an optical path including a wavelength filter, a mirror, a lens, and the like, as in a conventionally known device, and may be irradiated indirectly.

(3) Wavelength / Intensity The wavelength band of light is not particularly limited, but is 10 to 1000 nm, preferably 360 to 830 nm, and more preferably 430 to 630 nm. In the examples described later, a remarkable healing promotion effect has been confirmed particularly in the wavelength band of 470 to 630 nm.

  The light in the wavelength band can be extracted by passing light emitted from a light source through various wavelength filters, spectroscopes, diffractors and the like. Or you may use the light source which makes the said wavelength band the light emission wavelength range. Note that the irradiated light may be light in one wavelength region or two or more different wavelength regions.

The intensity of the light is not particularly limited, is preferably from 1 to 500 mW / cm ^2, more preferably 1~250mW / cm ^2.

(4) Irradiation time / frequency The irradiation time of light is not particularly limited, but one irradiation is about 10 to 7200 seconds, preferably about 30 to 7200 seconds, and more preferably 300 to 3600 seconds. Moreover, you may irradiate in the range for 2 to 24 hours as needed.
If it is 30 seconds or more, light sufficient for wound healing can be irradiated. If it is within 600 seconds, treatment in a short time is possible, so the patient burden is small. The number of times of irradiation is not particularly limited, but from the viewpoint of wound management of medical staff and patients, irradiation about once or twice a day is preferable.

  Moreover, the light to irradiate may be continuous light or pulsed light. In the case of pulsed light, irradiation may be performed by appropriately adjusting the ratio of time for turning on and off and setting the pulse speed and the like in a predetermined pattern. In the examples described later, it has been confirmed that higher healing is promoted by pulse irradiation than continuous irradiation.

In the light irradiation, the light energy (product of intensity and irradiation time) is 1 mJ / cm ^{2 to} 10 J / cm ² , preferably 1 mJ / cm ^{2 to 2} J / cm ² , more preferably 10 to 500 mJ / cm ^2. Do as follows. By setting the light intensity and irradiation time, that is, energy, within the above numerical range, a sufficient healing promoting effect can be obtained at the wound.

  The wavelength band, intensity, irradiation time, frequency, and the like of the light to be irradiated can be appropriately adjusted according to the type of wound, healing stage, site, and the like. Moreover, wound management can be performed efficiently by programming a predetermined irradiation pattern in a light source or the like.

2. Second healing promotion means The optical wound treatment apparatus according to the present invention includes second healing promotion means arranged in the wound part in addition to the first healing promotion means described above. The optical wound treatment apparatus according to the present invention can include one or more kinds of second healing promoting means described below. In addition, the optical wound treatment apparatus according to the present invention can provide an effect even when the first healing promoting means is used alone, but a higher effect can be obtained by using it together with the second healing promoting means.

(1) Dressing The second healing promoting means can be a dressing that covers the wound.

(I) Negative pressure closure As the covering material covering the wound portion, a material that encloses the wound portion in an airtight manner and can be connected to a negative pressure source can be employed. This dressing removes or discharges drainage fluid such as blood and exudate from the wound by connecting the wound part in an airtight manner and creating a negative pressure inside by a connected negative pressure source. The wound is cleaned by supplying a cleaning liquid to the inside by the liquid supply means. Hereinafter, this covering material is referred to as a “negative pressure closing cover”.

  FIG. 1 shows a preferred embodiment of a negative pressure closure cover. In the drawing, a negative pressure closing cover denoted by reference numeral 1 encloses the wound portion T in an airtight manner, and connects the suction communication port 11 connected to a negative pressure source (not shown) via the tube 2 and the tube 3. And a supply communication port 12 connected to a liquid supply means (not shown). In the figure, reference numeral 13 denotes an affected part insertion port into which a living body part (a hand in this case) where a wound exists is inserted, and reference numeral 14 denotes a treatment opening. It is preferable that the affected part insertion port 13 and the treatment opening 14 are configured to be hermetically sealed so that opening and sealing can be repeated. In the figure, reference numeral 15 denotes an irradiation window which will be described in detail later.

  The shape of the negative pressure closing cover 1 is not particularly limited as long as the wound part T can be enclosed in an airtight manner, and is a bag-like shape, a sleeve shape, or a sheet-like shape as disclosed in JP-A-2009-273669. It can be.

  In the present invention, the first healing promoting means may be provided either inside (on the wound part T) or outside of the negative pressure closing cover 1, but is preferably provided outside. In the case where the first healing promoting means is provided outside, the material of the negative pressure closure cover 1 is such that the light irradiated from the first healing promoting means is applied to the wound portion T in a state where the wound portion T is hermetically included. In order to be able to reach, what has optical transparency is used. Alternatively, a part of the negative pressure closing cover 1 may be formed of a material having optical transparency with respect to the light irradiated from the first healing promoting means and configured as the irradiation window 15. The light transmittance is, for example, preferably about 70% or more, more preferably 90% or more, with respect to light having a wavelength of 600 nm.

  A bellows-like structure is provided around the irradiation window 15 so that the direction of the irradiation window 15 can be adjusted so that the surface of the irradiation window 15 is always perpendicular to the light irradiated from the first healing promoting means. It is preferable.

  Moreover, in order to prevent the deformation | transformation at the time of applying a negative pressure, what is provided with the rigidity (koshi) for resisting the external force which causes a deformation | transformation is used for the material of the negative pressure closure cover 1 (or irradiation window 15). When the negative pressure closing cover 1 is deformed when a negative pressure is applied, wrinkles are generated, and the light irradiated from the first healing promoting means is scattered by the wrinkles, so that the desired light does not easily reach the wound part. It is. The rigidity of the negative pressure closing cover 1 (or the irradiation window 15) can be increased by laminating a plurality of film materials to form a cover or adjusting the type and thickness of the film. The irradiation window 15 preferably has higher rigidity and transparency than other portions of the negative pressure closing cover 1.

  Specifically, the material of the negative pressure closing cover 1 is, for example, a polyolefin such as polyethylene, low density polyethylene, high density polyethylene, or polypropylene; ethylene / vinyl acetate copolymer (EVA), ethylene / ethyl acrylate copolymer ( EEA), ethylene / methyl acrylate copolymer (EMA), ethylene / methyl methacrylate copolymer (EMMA), ethylene / methacrylic acid polymer (EMAA), ethylene / acrylic acid copolymer (EAA), etc. Polymers; polyvinyl chloride, polyvinylidene chloride; polyamides such as nylon 6 and nylon 66; polyesters such as polyethylene terephthalate and polybutylene terephthalate; polyvinyl alcohol; polyurethane; These materials may be used alone or in combination of two or more.

  The material of the negative pressure closing cover 1 is particularly preferably polyolefin or a chlorinated product thereof, an olefin copolymer, polyvinyl chloride, polyvinylidene chloride, polyurethane, polyester or polyamide.

  As described above, the material of the negative pressure closing cover 1 has a rigidity that can prevent deformation when a negative pressure is applied. If the rigidity is excessive, the negative pressure is applied when the negative pressure is applied. There is a possibility that the closure cover 1 may press the wound T and cause pain. In order to prevent this, only the irradiation window 15 of the negative pressure closing cover 1 is formed of a material having high light transmittance such as plastic or glass, and the other is formed of a material having low rigidity and following ability. May be. By increasing the followability of the negative pressure closure cover 1 to the living body surface, it is difficult to form an air layer between the negative pressure closure cover 1 and the wound part T, and light emitted from the first healing promoting means. It is also possible to prevent refraction. In addition, an air layer becomes a problem especially when irradiating light during washing | cleaning of the wound part T by a washing | cleaning liquid.

  Furthermore, by making the irradiation window 15 less flexible such as plastic or glass, the surface of the irradiation window 15 is flat against the light irradiated from the first healing promoting means even under negative pressure load. Thus, scattering of light can be prevented and a sufficient amount of light can be transmitted through the wound portion T. Moreover, since the negative pressure closure cover 1 is crushed from the periphery of the irradiation window 15 at the time of negative pressure load by comprising in this way, the surface of the irradiation window 15 is irradiated with the light irradiated from a 1st healing promotion means. On the other hand, it can be kept flat until the end.

  As shown in FIG. 2, a frame-like member 16 formed of a wire or a hard plastic may be detachably attached to the negative pressure closing cover 1 with an adhesive. The frame-like member 16 may be affixed on the outside of the negative pressure closure cover 1 or on the inside (side in contact with the wound). By arranging the frame-like member 16, it is possible to configure the irradiation window 15 in which wrinkles are unlikely to occur on the negative pressure closing cover 1. In addition, during negative pressure loading, wrinkles in the portion of the negative pressure closure cover 1 located between the frame-shaped members 16 are stretched by being sucked to the body side and irradiated from the first healing promoting means. Scattering of light can be prevented. In addition, the arrangement | positioning position and the number of arrangement | positioning of the frame-shaped member 16 are not limited to the example shown in FIG.

  The inner surface of the negative pressure closing cover 1 is preferably subjected to water repellent finishing. Thereby, when supplying a washing | cleaning liquid inside and washing | cleaning a wound, a water droplet can be made hard to remain in a cover after washing | cleaning, and the scattering by the water droplet of the light irradiated from a 1st healing promotion means can be prevented. In addition, light scattering due to exudate or the like can be prevented.

Irradiation of light from the first healing promoting means to the wound portion T can be performed both when a negative pressure is applied by the negative pressure closure cover 1 and when the negative pressure is released. The negative pressure load by the negative pressure closing cover 1 is preferably in the range of 0.01 to 300 mmHg, and more preferably in the range of 10 to 125 mmHg.
In addition, it is preferable to perform the load of the negative pressure to the wound part T using the negative pressure source which can load the negative pressure of the said range. For example, the present invention can be applied by connecting the inside of the negative pressure closing cover 1 and the negative pressure source in an airtight manner via a connecting means such as a tube 2 and operating the negative pressure source. As the negative pressure source, a conventionally known electric or manual pump can be employed.

The supply of the cleaning liquid into the negative pressure closing cover 1 can be performed by a liquid supply means connected to the supply communication port 12 via the tube 3. Further, the supplied cleaning liquid is discharged from the suction communication port 11 or a discharge port provided separately.
As the liquid supply means, a conventionally known electric or manual pump can be employed. Further, as the liquid supply means, it is also possible to use a sprayer or a natural drop type supply device using gravity.

  The cleaning liquid is not particularly limited, and a solution containing various drugs such as water, physiological saline, enzyme, cleaning agent, physiologically active substance, and growth factor is used.

  Irradiation of light from the first healing promoting means to the wound part T can be performed during and before and after the cleaning of the wound part T. However, when light irradiation is performed during the cleaning of the wound part T, Use a non-absorbable material. In this case, a cleaning liquid that does not contain a substance that deteriorates due to light is used.

  In the optical wound treatment apparatus according to the present invention, it is preferable to provide a light-transmitting pad between the negative pressure closure cover 1 and the wound part T. The pad is more preferably water-absorbing.

  Here, as a pad, what was shape | molded with resin which has transparency or translucency, and was equipped with the liquid channel | path by the pleat, the unevenness | corrugation, or opening (for example, the thing of Penrose drain shape etc.) is mentioned. The same material can be used for the negative pressure closing cover 1 as the material of the pad. Further, fiber materials such as knitted fabrics, woven fabrics, and nonwoven fabrics having openings (mesh) that transmit light, resin materials such as silicone, foam materials, and the like can also be used.

  Furthermore, the pad may have higher rigidity than the negative pressure closing cover 1. Even in such a case, generation of wrinkles can be prevented during negative pressure loading.

When irradiating light to a wound, if blood from the wound, exudate, necrotic tissue, etc. are present in the wound, or if there is a space between the wound and the dressing, light from the blood or exudate In some cases, the desired light does not reach the wound part due to the effect of light scattering caused by absorption / non-permeation of light and wrinkles formed on the covering material, and phototherapy may not be performed effectively.
However, the optical wound treatment apparatus according to the present invention maintains the wound portion T under negative pressure by the negative pressure closure cover 1, and discharges blood or exudate from the wound or the negative pressure closure cover 1 and the wound portion T. The air layer formed between the two can be removed by suction, and light from the first healing promoting means can be irradiated. Thereby, absorption and non-permeation of light due to blood and exudate and light scattering due to wrinkles formed on the covering material can be prevented, light can be efficiently irradiated to the wound, and healing can be further promoted. Furthermore, since the wound part T can be forced into a moist environment by suction, drying of the wound can be prevented during the treatment by light irradiation. In addition, it is thought that healing can be further promoted because light can be efficiently irradiated to cells gathered in the wound due to the negative pressure load.

  The optical wound treatment device according to the present invention cleans the wound with the cleaning liquid supplied to the negative pressure closure cover 1 while keeping the wound portion T under negative pressure, and emits light from the first healing promoting means. Can be irradiated. As a result, wound healing delay factors such as necrotic tissue, bacteria, and drainage can be positively removed, light can be efficiently irradiated to the wound and cells, and healing can be further promoted. Furthermore, since the wound part T can always be in a moist environment by washing, drying of the wound can be prevented during treatment by light irradiation.

(Ii) Gel film As the covering material covering the wound part, a cloth-like, gel-like or film-like thing closely attached to the wound part may be employed. This covering material prevents invasion of germs from the outside and keeps the wound part in a moist environment. Hereinafter, this coating material is also simply referred to as “gel” or “film”.

  As the covering material, fiber materials such as knitted fabrics, woven fabrics and nonwoven fabrics, foam materials, hydrocolloid materials, film materials, hydrogel materials and the like are used. Of these, film materials and hydrocolloid materials are preferred. In addition, a hydrogel material is particularly preferable from the viewpoint of water absorption and transparency.

Examples of film materials include polyurethane; polyester such as polyethylene terephthalate and polybutylene terephthalate; polyamide such as nylon 6 and nylon 66; polyolefin such as polyethylene, low density polyethylene, high density polyethylene and polypropylene; ethylene / vinyl acetate copolymer Polymer (EVA), ethylene / ethyl acrylate copolymer (EEA), ethylene / methyl acrylate copolymer (EMA), ethylene / methyl methacrylate copolymer (EMMA), ethylene / methacrylic acid polymer (EMAA), ethylene / Examples thereof include olefin copolymers such as acrylic acid copolymer (EAA); polyvinyl alcohol; polyvinyl chloride, polyvinylidene chloride; silicone;
More preferably, polyurethane, polyester, polyamide or the like having good water vapor permeability and less disturbing insensitive transpiration can be used. In addition, these materials may be used independently and may mix and use 2 or more types.

Examples of hydrogel materials include polyethylene oxide, polyvinyl alcohol, polyvinyl pyrrolidone, carboxymethyl cellulose and its salt compounds, starch, carrageenan, alginic acid and its salt compounds, polyacrylic acid and its salt compounds, polyglutamic acid and its salt compounds, and the like. It is done.
More preferably, polyvinyl alcohol, polyvinyl pyrrolidone, carboxymethyl cellulose, and a salt compound thereof are used. These materials may be used in combination according to the purpose.

  As the material of the gel film, a material having light transparency is used so that the light irradiated from the first healing promoting means can reach the wound part in close contact with the wound part. Furthermore, a material that maintains transparency even when absorbing blood or exudate from a wound is particularly preferable. The light transmittance is, for example, preferably about 70% or more, more preferably 90% or more, with respect to light having a wavelength of 600 nm. Further, the gel film preferably has a smooth surface in order to prevent scattering of light irradiated from the first healing promoting means.

  An antibacterial agent may be blended in the gel film. Thereby, bacteria around the wound can be excluded and healing of the wound can be promoted.

  The optical wound treatment apparatus according to the present invention can irradiate light from the first healing promoting means while preventing invasion of germs into the wound part by a gel film or the like and keeping the wound in a moist environment. Thereby, in the treatment by light irradiation, drying of a wound can be prevented and healing of a wound can be promoted further.

(2) Electrical stimulation The second healing promoting means may be a conductive member that imparts electrical stimulation to the wound. The conductive member may be an electrode that is disposed on the wound surface or a living body surface in the vicinity thereof and connected to a power source. It is preferable to apply a gel to the electrode so that the electrode can be attached to the surface of the living body.

  In addition, a photovoltaic cell may be disposed as a conductive member on the wound surface or a living body in the vicinity thereof, and the wound may be irradiated with light from the first healing promoting means, and this light may be converted into electrical stimulation by the photovoltaic cell. . In this case, the apparatus can be downsized as compared with the case where an electrode and a power source are provided.

  The current value supplied to the conductive member for applying electrical stimulation to the wounded part is preferably 5 μA to 5 mA, and preferably 50 to 700 μA, from the viewpoint of cell stimulation threshold and safety to the living body. More preferred.

It is desirable to change the current value of the electrical stimulation indefinitely and / or intermittently. Specifically, it is desirable that there is a range of current variation of several μA to several tens of mA, based on cell damage current and action potential. For example, a current variation width of 10 μA or more for a wound close to the surface layer and 5 mA or more for a deep wound are considered to be effective. Further, even if the current is a constant value, it may be turned on and off repeatedly and energized intermittently.
In addition, by incorporating a pulse transformer, an inverter, or the like to form a pulse wave such as a rectangular wave, a triangular wave, or a sine wave, the same action and effect of electrical stimulation as that of the current variation may be obtained.

  The voltage value of the electrical stimulation is appropriately set depending on the depth of the wound. In the case of microcurrent nerve stimulation (MENS) or iontophoresis, the voltage value is preferably 0.1 to 10 V, and in the case of functional electrical stimulation (FES) or electrical muscle stimulation (EMS), the voltage value is preferably 1 V to 50 V. As with the current value, it is desirable that the voltage value be changed indefinitely and / or intermittently.

  The frequency of electrical stimulation is preferably 10 Hz to 50,000 Hz, more preferably 10 Hz to 20,000 Hz in consideration of the influence of polarization of the cell membrane or the like. Exceeding the upper limit of this frequency range may cause heat generation or reduced sensing. As with the current value, it is desirable that the frequency be changed indefinitely and / or intermittently. In order to prevent the occurrence of pain due to electrical stimulation, it is desirable to control the frequency by providing a period in which continuous pulses are generated and a period in which no continuous pulses are generated.

  In order to apply optimal electrical stimulation from the conductive member to the wound, the frequency and voltage are determined according to the distance from the conductive member placement site to the wound, and the reactivity and polarization characteristics of the wound tissue The frequency is determined according to

  The optical wound treatment apparatus according to the present invention can apply electrical stimulation to a wound part by a conductive member, and can amplify a cell activation signal by light irradiation from the first healing promoting means. Thereby, synthesis of RNA and DNA and differentiation / proliferation of cells can be promoted to further promote wound healing.

(3) Electromagnetic stimulation / magnetic stimulation / thermal stimulation, drug, oxygen As the second healing promoting means provided in the optical wound treatment apparatus according to the present invention, in addition to the covering material and the conductive member, the following means are provided. It may be adopted.

(I) Electromagnetic stimulation / magnetic stimulation / thermal stimulation Means for applying electromagnetic stimulation / sonic stimulation / thermal stimulation to the wound part during or before light irradiation to the wound part from the first healing promoting means.

  According to the second healing promoting means, the blood flow in the wound can be stimulated / improved by electromagnetic stimulation / sonic stimulation / thermal stimulation, and the healing promoting effect of the first healing promoting means can be enhanced. It should be noted that the sonic stimulation includes spraying a wound solution by using a chemical solution containing a drug as an aerosol mist by ultrasonic waves.

(Ii) Drug A drug that is applied to the wound part or contained in the covering material before irradiation of light from the first healing promoting means to the wound part.

  Examples of the drug include a photoexcited substance, a phosphorescent substance, and an antioxidant substance.

  As the photoexcited substance, for example, titanium oxide is applied or contained in the covering material, and oxygen generated by light irradiation is supplied to the wound part. In wounds, oxygen is consumed for cell renewal, and oxygen tends to be deficient. Therefore, healing can be promoted by supplying oxygen from the outside to compensate for the lack of oxygen. In addition, the compounding quantity of the titanium oxide in a coating | covering material is suitably adjusted from viewpoints, such as the light transmittance of a coating | covering material.

  Examples of the phosphorescent material include strontium aluminate containing components such as high-purity alumina, strontium carbonate, europium, and dysprosium. By applying the phosphorescent substance to the coating or covering material, the excited phosphorescent substance emits light even after the completion of the light irradiation, so that the wound can be irradiated with light. Thereby, even if light irradiation by the 1st healing promotion means is not performed, light will be continuously irradiated to a wound part, for example, wound healing can be promoted also at the time of bedtime etc.

  Antioxidants include natural and synthetic antioxidants. Among these, there are fat-soluble and water-soluble natural antioxidants. Examples of fat-soluble antioxidants include vitamin E, carotenoids (such as β-carotene and canthaxanthin), retinoids, ubiquinone (coenzyme Q), and flavonoids (such as morin, catechin, and rutin). Examples of water-soluble antioxidants include vitamin C, uric acid, bilirubin, and albumin. Synthetic antioxidants include ebselen (brain protective agent), allopurinol (ventilation treatment agent), probucol (hyperlipidemia treatment agent), captopril (hypertensive agent), Ca antagonists (antihypertensive agent) such as nifedipine, nicardipine, etc. Is mentioned.

  By applying an anti-oxidant to the wound or containing an anti-oxidant in the dressing, the active oxygen concentration in the wound is lowered, and cell production and / or activation is attempted, and excessive cell death occurs. Can be prevented. Thereby, wound healing can be promoted.

(Iii) Oxygen Means for supplying oxygen to the wound part at the time of irradiation of the wound part from the first healing promoting means or before and after.

  As described above, oxygen is consumed in the wound for cell renewal, and oxygen tends to be deficient. By supplying oxygen from the outside by this second healing promoting means, oxygen deficiency is compensated. , Can promote healing. The concentration of oxygen to be supplied is not particularly limited, but a range of 21% to 100% is preferable.

  Moreover, oxygen may not be supplied directly to the wound part, but may be supplied via circulating blood by causing the user (patient) of the optical wound treatment apparatus according to the present invention to suck high-concentration oxygen. . High-concentration oxygen increases the amount of dissolved oxygen in the blood, and dissolved oxygen can pass through capillaries, so that oxygen can be supplied to every corner of the living body. The concentration of oxygen to be sucked is not particularly limited, but it is preferable that the oxygen concentration in the alveoli is 60% or less.

3. Light Control Unit The optical wound treatment apparatus according to the present invention may include a light control unit that controls the characteristics of light emitted from the first healing promotion unit. The optical wound treatment apparatus further includes a detection unit that detects information about the wound part, a storage unit that stores an output signal from the detection unit, and an analysis unit that determines the state of the wound part based on the output signal. Preferably it is. In this case, the light control unit can be configured to receive the signal output from the analysis unit and control the characteristics of the light emitted from the first healing promoting means.

As the detection unit, a camera that acquires an image of the wound part as information about the wound part, a thermography that measures the temperature of the wound part as the same information, a moisture transpiration measuring device (TEWL meter) that detects humidity as the same information, Examples of the information include an odor determination device that detects an odor.
Information on the image, temperature, humidity or odor of the wound part detected by the detection part is converted into an electrical signal, output and held in the storage part, and also read out by the analysis part. The storage unit and the analysis unit may be configured by a device in which a general-purpose computer including a CPU, a hard disk, a memory, and the like is loaded with a program for performing wound state determination and light characteristic control as described below.

  That is, the analysis unit compares the information on the image, temperature, humidity, or smell of the wound detected by the detection unit with the information acquired at different time points or the reference information stored in advance, and The conditions such as area (size), depth, color, amount of blood and exudate from the wound, components and pH of the exudate, amount of granulation cells, amount of granulation, and presence / absence of inflammation / infection are determined. And an analysis part controls characteristics, such as a wavelength and intensity | strength of light irradiated to a wound part from a 1st healing promotion means, irradiation time, and frequency according to a determination result.

  As a specific example of determination and control by the analysis unit, for example, an image of an initial state of a wound part and a current image are compared to analyze how much the current wound area is reduced. As a result of the analysis, when the reduction ratio of the wound area is less than 50%, pulse irradiation is performed for a predetermined time and a predetermined number of times at a wavelength of 590 nm. When the reduction ratio is 50% or more, irradiation is performed with light, intensity, irradiation time, frequency, etc. in other wavelength ranges in accordance with the reduction ratio.

  Even if the optical wound treatment apparatus according to the present invention is provided with the above-described light control unit, it is naturally possible for a person to determine the state of the wound and control the light characteristics as necessary. For example, a person obtains information about a wound part, inputs the information to a device from a user interface such as a keyboard or a mouse, and the light control unit emits light emitted from the first healing promoting means based on the input information It can be configured to control the characteristics of

  In addition, the optical wound treatment apparatus according to the present invention may be configured to accumulate and store the amount of energy and time of light irradiated for each treatment round. In this case, the device automatically determines that the reduction rate of the wound area has reached 50% or more when the accumulated energy amount or accumulated time reaches the preset total energy amount or total time. It can be programmed to allow the user to select other wavelength ranges and the like.

<Example 1>
1. Examination of healing promotion effect of full-thickness skin defect wounds in rats In this example, a full-thickness skin defect wound created on the dorsal side of healthy rats and immunosuppressed model rats was subjected to a second coating with light-transmitting material. Healing was promoted by using the optical wound treatment apparatus according to the present invention which constituted the healing promotion means.

(1) Animals Wister rats, 8-week-old females were used as healthy rats. As immunosuppressive model rats, Wister rats, 8 weeks old, females, administered with the antineoplastic agent cyclophosphamide were used. Cyclophosphamide was dissolved in physiological saline (manufactured by Otsuka Pharmaceutical Co., Ltd.) on the day before creation of the wound, and then injected through the tail vein at a concentration of 150 mg / kg body weight.
(2) Creation of wound A circular full-thickness skin defect wound having a diameter of 25 mm was created on the dorsal side of the rat using a scalpel. Two defect wounds were created on the dorsal side of each rat. Here, the full-thickness skin defect wound refers to a wound in which the epidermis, dermis and subcutaneous tissue are defective.
(3) Light irradiation Commercially available LEDs (LAJ4C, manufactured by Iwasaki Electric Co., Ltd.) with wavelengths of 590 nm and 630 nm were used as the light source of the first healing promoting means. Light irradiation was performed by continuous irradiation or pulse irradiation (250 ms on, 100 ms off), and was performed once a day under the conditions shown in Table 1 below.
(4) Coating material A commercially available wound closure dressing (Tegaderm, Sumitomo 3M Co., Ltd.) was used as a coating material having light transmittance. The wound was covered with a covering material and irradiated with light.

  The results of recording the progress of wound healing using three animals for each light irradiation condition are shown in FIG. 3 and FIG. FIG. 3 shows the results of healthy rats, and FIG. 4 shows the results of immunosuppressed model rats. Tables 2 and 3 show the number of days required to reduce the wound size to 50% for each light irradiation condition. Table 2 shows the results of healthy rats, and Table 3 shows the results of immunosuppressed model rats.

  In healthy rats, it was confirmed that healing was promoted in the light irradiation group as compared to the control group in which the wound part was covered with a covering material and no light irradiation was performed. The healing promoting effect was higher with light irradiation at 590 nm than light irradiation with a wavelength of 630 nm. In addition, higher healing promotion effect was obtained by pulse irradiation than continuous irradiation. Particularly, in the case of pulse irradiation with a wavelength of 590 nm, the number of days required to reduce the size of the wound to 50% is 7.9 days (condition 3) or 10.1 days (condition 4), and the control group (15. It was almost halved compared to 4 days), and a high effect was confirmed. In the immunosuppressed model rats, healing was confirmed in the light irradiation group compared to the control group.

<Example 2>
2. Examination of the healing promotion effect of full-thickness skin defect wounds in mice In this example, a full-thickness skin defect wound created on the dorsal side of healthy mice and diabetes model mice was subjected to a second coating material with light transmittance. Healing was promoted by using the optical wound treatment apparatus according to the present invention which constituted healing promoting means.

(1) Animals As healthy mice, db / + m mice (CLEA Japan, Inc.), 10 weeks old, females were used. As a diabetes model mouse, db / db mouse (CLEA Japan, Inc.), 10 weeks old, female was used.
(2) Creation of wound A wound was created by the same method as in Example 1.
(3) Light irradiation Commercially available LED (LAJ4C, manufactured by Iwasaki Electric Co., Ltd.) having a wavelength of 590 nm was used as the light source of the first healing promoting means. Light irradiation was performed once a day under the conditions of pulse irradiation (250 ms on, 100 ms off), intensity 6.3 W / m 2, time 1.8 min, energy 0.05 J / cm ² (see condition 3 in Table 1). .
(4) Coating material The same coating material as in Example 1 was used.

  The results of recording the progress of wound healing using 7 animals are shown in FIGS. FIG. 5 shows the results of healthy mice, and FIG. 6 shows the results of diabetes model mice.

  In healthy mice and diabetic model mice, it was confirmed that healing was promoted in the light irradiation group as compared with the control group. In healthy mice, the number of days required to reduce the wound size to 50% was 10.0 days in the control group compared to 7.6 days (75%) in the light irradiation group. It was. The same number of days in the diabetes model mice was 10.0 days (64%) in the light irradiation group compared with 15.7 days in the control group. The healing promoting effect was more prominent in diabetic model mice than in healthy mice. The numbers in parentheses are control ratios.

<Example 3>
1. Examination of angiogenesis promoting effect in wound part In the present example, the present invention in which the second healing promoting means is constituted by a covering material having light permeability for the full thickness skin defect wound created on the dorsal side of a healthy mouse The optical wound treatment apparatus according to the present invention was irradiated with light, and the effect of promoting healing and angiogenesis was examined.

(1) Animals As healthy mice, db / + m mice (CLEA Japan, Inc.), 10 weeks old, females were used.
(2) Creation of wound A wound was created by the same method as in Example 1.
(3) Light irradiation Commercially available LEDs (LAP type visible light LED lamps, manufactured by Iwasaki Electric Co., Ltd.) having wavelengths of 470, 590, 620, 785, and 875 nm were used as the light source of the first healing promoting means. Light irradiation was performed once a day by continuous irradiation.
(4) Coating material The same coating material as in Example 1 was used.
(5) Observation of new blood vessels On the 17th day after the wound was created and the treatment was started, the animals were experimentally killed. The wound skin was sampled, fixed, embedded, and stained by a conventional method, and the newly vascularized blood vessels were observed histopathologically.

  The results of recording the progress of wound healing for each wavelength condition are shown in FIG. FIG. 8 shows the number of new blood vessels observed in the wound part for each wavelength condition.

  In all wavelength conditions, promotion of healing was confirmed in the light irradiation group as compared with the control group, and in particular, in the conditions of wavelengths 470 and 590 nm, the number of days required to reduce the wound size to 50% was remarkable. The shortening was confirmed. Under these wavelength conditions, more neovascular vessels were observed in the wound than in the other wavelength conditions, and it was speculated that promotion of angiogenesis promoted wound healing.

  The optical wound treatment apparatus according to the present invention can be suitably used for promoting healing of burns, pressure ulcers, diabetic ulcers, varicose ulcers, surgical wounds, and other injuries.

DESCRIPTION OF SYMBOLS 1 Negative pressure closure cover 11 Suction communication port 12 Supply communication port 13 Affected part insertion port 14 Treatment opening 15 Irradiation window 16 Frame-like member 2, 3 Tube T Wound part

Claims (5)

A first healing promoting means for irradiating a target site of a living body with light of a predetermined wavelength band;
An optical wound treatment device comprising: second healing promoting means disposed at the target site.   2. The optical wound treatment apparatus according to claim 1, wherein the second healing promoting means is a covering material that covers the target site and has transparency to the light emitted from the first healing promoting means.   The optical wound treatment apparatus according to claim 2, wherein the covering material includes the target portion in an airtight manner and has a shape that can be connected to a negative pressure source.   The optical wound treatment apparatus according to claim 2, wherein the covering material is formed in a gel shape or a film shape in close contact with the target site.   An optical wound treatment apparatus comprising means for irradiating a target region of a living body with light of 430 to 630 nm.

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