RU163627U1 - DEVICE FOR LOCAL TREATMENT AND DYNAMIC OBSERVATION OF SURFACE FUSAL RAS - Google Patents

Abstract

A device for local treatment and dynamic observation of superficial purulent wounds, containing a source of negative pressure, connected with tubes to a waste collection container and a tube for removing waste from a wound, a pump for supplying medicinal solutions to the wound, through a system of electromagnetic valves to regulate the supply of medicinal solutions, with containers for medicinal solutions, a microprocessor electrically connected to electromagnetic valves, a pump and a source of negative pressure, and elastic a film, with an adhesive on the base attached above the wound, while the film is equipped with a removable round-shaped lid with a diameter of up to 150 mm of translucent material, which is attached to the film by means of a two-part elastic-elastic sealing ring, one part of which is soldered to lid and has a rib, and the other is soldered to the film and has a groove.

Description

The proposed utility model can be applied in purulent surgery and is intended to treat shallow superficial purulent wounds regardless of the phase of the wound process.

At the moment, a large number of devices designed to treat wounds are known, but the treatment of shallow superficial purulent wounds has its own characteristics.

There is a device for treating infected and purulent wounds (Obolensky VN Device for treating infected and purulent wounds RF Patent for utility model No. 131622. - publ. 08/27/2013. - Bull. No. 14. - P. 2), containing on the wound surface, a small-mesh sponge, a film for isolating and sealing the surgical field, a drainage system equipped with a tube, one end of which is connected to a sealed cavity of the surgical field, and the other to a container for collecting detachable exudate connected to a vacuum pump equipped with an electric a drive, a bactericidal air filter, a vacuum sensor, a microprocessor, an analog-to-digital converter, a noise sensor to reduce the noise of a vacuum sensor and an audible buzzer, while the input of the vacuum sensor through a capillary tube is connected to a vacuum pump, the output of the vacuum sensor through an amplifier is electrically connected to the reduction element noise interference of the vacuum sensor, the output of which is connected to the input of an analog-to-digital converter, the output of which is connected to the input of the microprocessor, the outputs of which are respectively connected to The electrical drive of the vacuum pump, with audible buzzer and a display.

The device has the following disadvantages:

a) there is no possibility of carrying out therapeutic and diagnostic manipulations in the wound without first completely removing the device;

b) the placement in the wound of small-sized components excludes the possibility of dynamic monitoring of the course of the wound process throughout the provision of therapeutic measures and makes it difficult to remove from the wound the dense component of the wound discharge;

c) there is no possibility of using medicinal solutions for the treatment of wounds.

Known external patient exposure system and method of its application (patent No. 2429887, A61M 35/00, published September 27, 2011), adopted as the closest analogue. The device comprises an external means comprising an external fluid transfer component for transferring fluid from a wound or incision, and an upper tissue located on top of said external component in contact with the surrounding skin surface. The fluid transfer component comprises a porous central portion. The upper napkin has an outlet for fluid. A negative pressure source is connected to the exhaust channel. A pad of absorbent material completely encloses the central part and forms a layer between the upper cloth and the porous surface of the fluid transfer component in the upper part of the device. The gasket forms a layer between the fluid transfer component and the skin surface at the wound or incision in the lower part of the device and is configured to be absorbed to increase the efficiency of fluid transfer from the wound or incision to the fluid transfer component, and from the fluid transfer component to the outlet. The external means of exposure can advantageously be placed over the seam line or staples, while it contains a primary transfer component comprising a strip of porous material, such as rayon, applied directly to the patient to absorb or transfer fluid to the secondary transfer component containing sponge or foam . Between the transfer elements, a lower napkin is provided for liquid to pass between them through the napkin passages, such as a slot. On top of the secondary component of the transfer placed the upper cloth, which covers the surface of the skin. The patient exposure means is connected to a vacuum source, such as a vacuum closing aid, a wall-mounted suction device, or a mechanical suction pump. In a manual embodiment, a final fluid volume reservoir with a shut-off valve is used to disconnect the drainage after collecting a sufficient amount of fluid. In the automatic control embodiment, a microprocessor is used, adapted for programming, providing a response to various input data to control the operation of the vacuum source. The proposed method for treating a closed wound or incision includes three stages of controlling the effect on the fluid, which correspond to various stages of the healing process. At the first stage, active drainage control is performed. In a second step, the components can be disconnected independently of one another or in series. In a third step, the secondary transfer component may optionally be left in place to protect and facilitate the evacuation of any residual fluid from the seam / staple line through the primary transfer component.

The disadvantages of the device are:

a) the use of a sealing strip for access to the wound gives a limited access field for performing manipulations in the wound, in addition, there is a high risk of deformation of the operation panel during the treatment and diagnostic procedures. In addition, the need to increase the working field requires an additional expansion of the existing clearance between the edges of the sealing strip, which in turn increases the complexity of the manipulation and can lead to the peeling of the operating panel from the outer wipe;

b) the use of porous materials excludes the possibility of carrying out visual dynamic control over the course of the wound process without performing partial dismantling of the device;

c) the use of porous materials makes it difficult to drain the dense component of the wound and requires the replacement of these components as they become contaminated.

Objective: to create a device for the treatment of superficial purulent wounds, which allows for wide enough access for manipulation in the wound, to conduct a dynamic visual assessment of the course of the wound process during operation of the device without performing partial dismantling of the device components, to reduce the laboriousness of the manipulations carried out in the wound, to eliminate the need for frequent replacement device components or their destruction during operation.

The essence of the device for the treatment of superficial purulent wounds is that for the treatment of wounds using a device containing a source of negative pressure, a pump for supplying medicinal solutions, a valve system for regulating the supply of medicinal solutions, a microprocessor and switches to ensure the operation of the device in automatic mode, containers for drugs solutions and waste collection, an elastic film with an adhesive on the base of the film, characterized in that the film is equipped with a removable rounded cover diameter up to 15 cm from the translucent material, wherein the cover attachment to a film is carried out by resiliently-elastic sealant ring

The technical result of the proposed solution is:

- the possibility of round-the-clock local treatment of wounds with medicinal solutions while maintaining an extensive access field to the wound through the use of a removable round-shaped lid.

Additional technical results:

- the possibility of dynamic monitoring of the wound, including during operation of the device, without partial dismantling of the device due to the cover located above the wound from a translucent material;

- the minimum complexity of obtaining an extensive access field to the anne to perform diagnostic and treatment procedures;

- lack of need for frequent replacement of porous and foamed components as they become contaminated with wound;

- lack of materials with the ability to destroy and contaminate the wound during operation.

The proposed device for better understanding is shown in figures 1 (general view of the device), 2 (mounted on the wound component parts of the device, side view), 3 (mounted on the wound component parts of the device, top view), 4 (fixation elements of the seal ring) where :

1 - containers with medicinal solutions; 2 - tubes for supplying medicinal solutions; 3 - the direction of movement of medicinal solutions; 4 - electromagnetic valves; 5 - connecting wires; 6 - pump for supplying medicinal solutions; 7 - microprocessor; 8 - personal computer; 9 - source of negative pressure: 10 - capacity for collecting waste; 11 - tube for waste disposal; 12 - the bottom of the wound; 13 - intact skin around the wound; 14 - adhesive at the base of the film; 15 - tube for the supply of medicinal solutions and waste disposal; 16 - direction of movement of waste; 17 - a cavity formed by an elastic film, the bottom and walls of the wound; 18 - elastic film; 19 - a ring seal; 20 - a removable cover made of translucent material with a diameter of 150 mm., 21 - the edge of the seal ring; 22 - groove of the seal ring, 23 - window.

The device is used as follows:

Medicinal solutions from containers 1 are supplied through tubes for supplying medicinal solutions 2 in accordance with the directions of movement of the medicinal solutions 3 in the direction of the wound. The feed is carried out using a pump for supplying medicinal solutions 6 and is regulated by solenoid valves 4. Automatic operation of the device is possible using microprocessor 7, combined by connecting wires 5 with solenoid valves 4, a pump for supplying medicinal solutions 6, a source of negative pressure 9. The programming and tuning of the microprocessor 7 is carried out using a personal computer 8, combined with connecting wires 5. For operation of the device over the wound by means of adhesive to the base film 14 is attached elastic film 18, the attachment is carried out at a distance from the bottom of a wound 12, bypassing the intact portions 13 to reduce the pain of the patient during attachment and removal of the film. The supply of medicinal solutions is carried out through a tube for supplying medicinal solutions and waste 15 to the cavity 17 formed by an elastic film 18, the bottom of the wound 12 in accordance with the directions of movement of the medicinal solutions 3. After the supply and implementation of the medicinal effect on the wound, the waste is discharged through the supply tube solutions and waste disposal 15 in accordance with the directions of movement of the waste 16 using a source of negative pressure 9, then through the tube for the disposal of waste 11 into a container for ora waste 10. dynamic visual monitoring of the wound through removable cap 20 and the cavity formed by the elastic film 17 and the bottom of the wound, the filled medicinal solutions. A removable cover of translucent material 20 is attached to the elastic film 18 using a two-part seal ring 19, the edge of the seal ring 21 being soldered to the cover 20, and the groove of the seal ring 22 with the film 18. If a visual inspection reveals the need treatment and diagnostic manipulations in the wound, the device is turned off, a removable cover of translucent material 20 is removed from the film 18 by removing the ribs 21 from the groove 22. After that, an extensive direct access to the bottom of the wound 17 is formed, through the window 23, p Moreover, the round shape of the window 23 makes it possible to manipulate the wound without the need for additional mechanical impact on the wound walls, and the elastic-elastic ring-seal 19, represented in this case by the groove of the ring-seal 21, does not allow the elastic film 18 to deform and does not affect the adhesive on the base of the film 14. After completion of the manipulation, a removable cover of translucent material 20 is attached to the film 18 by fixing the ribs 21 in the groove 22, thus closing the window 23, after which the device includes the operating mode set by the microcontroller 7 is continued. Removing and securing a removable cover of translucent material 20 depends on the course of the wound process and can be performed repeatedly without removing the film 18 and removing adhesive from the skin surface at the base of the film 14.

Justification of the results.

A series of experiments on laboratory animals was carried out to determine the effect on the course of the wound process of the proposed device for local treatment and dynamic observation of superficial purulent wounds. Male rabbits weighing 2.5-2.7 kg were used as experimental animals. Animals were divided into two groups: control (n = 10) and experimental (n = 10). In the control group, treatment was carried out according to the method of treating wounds under an ointment dressing (dressing once a day with wound debridement with an aqueous solution of chlorhexidine), and in the main - according to the method for treating superficial wounds in a liquid medium described above. After cleansing the wound, it was sutured. The time of wound cleansing (transition to the 2nd phase of the wound process) was estimated.

A purulent wound was modeled according to the following procedure: on the eve of a laboratory animal, the hair was cut and shaved on the middle and lower third of the back. The next day, after twice treating the surgical field (shaved area) with an alcohol solution under local anesthesia with a 0.5% novocaine solution, a 5 cm long incision was made. Subcutaneous tissue, superficial and lumbar-spinal fascia, and intrinsic fascia of the rectus rectifier were dissected. A gauze ball with a diameter of 10 mm, impregnated with 1 ml of liquid with a daily culture of the pathogenic strain of Staphylococcus aureus, was introduced into the resulting wound. Then the wound was closed by stitching the edges of the skin over the ball with a purse string suture. 4 days after the implantation of infected foreign bodies, skin sutures were removed, the foreign body, a gauze ball, was removed and the formed wound was reconstructed, which was further treated using the proposed device. After preliminary treatment of the purulent wound, sanitation with an antiseptic oxidizing agent, an elastic film was attached over the wound with an adhesive base, the washing solutions were flowed under the film: antiseptic, antiseptic oxidizing agent - sodium hypochlorite and osmotically active agent - sodium chloride, the film was changed after 3-4 days.

In the first (purulent-necrotic) phase of the wound healing process, an antiseptic agent (0.05% aqueous solution of chlorhexidine at a rate of 20 ml / min) was supplied into the cavity formed between the wound and a transparent water-air-tight film for 10 minutes, the exposure duration of which ( in the “pause” mode) was 10 minutes, then an antiseptic oxidizing agent (sodium hypochlorite with a concentration of 900 mg / ml at a rate of 20 ml / min) was supplied for 1 minute, the exposure duration of which (in the “pause” mode) was 15 minutes. Then provided an active outflow of the contents of the cavity, limited by a transparent water-air-tight film using a peristaltic pump. Immediately after this, an osmotically active agent (sodium chloride at a concentration of 2.5% at a rate of 20 ml / min) was supplied for 4 minutes, the exposure time of which (in the “pause” mode) was 15 minutes. The above cycle of supply and removal of washing solutions was carried out continuously throughout the first phase of the wound process. In the second (proliferative) phase of the wound healing process, the duration of sodium chloride administration was reduced to 2 minutes, and the concentration of sodium chloride was reduced to 1.5%. In the third phase of the wound healing process, the administration of an antiseptic was reduced to 5 minutes, the antiseptic oxidizing agent was not administered, and the concentration of sodium chloride was reduced to 1%. The indicated cycle of supply and removal of washing solutions was continued until large juicy granulations were formed in the wound and the epithelization process started, after which the film was dismantled.

On the 2nd and 4th day, based on the results of examination of the wounds, it was decided to conduct ultrasonic cavitation in the experimental group. The manipulation was carried out through a window obtained by removing the removable cover from a translucent material, after the manipulation the window was closed by fixing a removable cover from a translucent material using an elastic-elastic seal ring (Fig. 5).

After the final cleansing, the wound was sutured, the time of cleansing in the control group (Fig 6.) was 8.1 ± 0.87 days, in the experimental group (Fig. 7) 4.6 ± 0.6 days.

Thus, the proposed device is more efficient than the closest analogue, and allows you to get quite wide access for manipulation in the wound, to conduct a dynamic visual assessment of the course of the wound process during operation of the device without performing partial dismantling of the components of the device, to reduce the complexity of the manipulations carried out in the wound, eliminate the need for frequent replacement of device components.

Claims (1)

A device for local treatment and dynamic observation of superficial purulent wounds, containing a source of negative pressure, connected with tubes to a waste collection container and a tube for removing waste from a wound, a pump for supplying medicinal solutions to the wound, through a system of electromagnetic valves to regulate the supply of medicinal solutions, with containers for medicinal solutions, a microprocessor electrically connected to electromagnetic valves, a pump and a source of negative pressure, and elastic a film, with an adhesive on the base attached above the wound, while the film is equipped with a removable round-shaped lid with a diameter of up to 150 mm of translucent material, which is attached to the film by means of a two-part elastic-elastic sealing ring, one part of which is soldered to lid and has a rib, and the other is soldered to the film and has a groove.

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