RU2192797C2 - Method for treating prolonged unhealing wounds - Google Patents

Abstract

FIELD: medicine, surgery. SUBSTANCE: at the first stage one should conduct aeroionotherapeutic seances for 10-25 d. During the second stage before applying the bandages with water- soluble ointments one should transfer the cultures of film matrix-based allofibroblasts onto the wound. The method enables to activate regenerative processes in the wounds that provides their complete healing. EFFECT: higher efficiency of therapy.

Description

 The invention relates to medicine, in particular to methods for treating nonhealing wounds.

 Known methods for treating nonhealing wounds using enzymes, for example, iruksol (see MA Trunin, AS Emelyanov, “The use of Iruxol in a surgical clinic.” J. “Surgery”, 1982, N 8, p. 88) , trypsin (see P. I. Tolstykh et al. "The effect of biologically active dressings of wounds on the course of the wound process." J. "Herald of surgery", 1987, N 3, p. 57).

 However, the use of enzyme preparations only helps to cleanse wounds from necrotic tissues, fibrinous plaque, purulent discharge, but does not affect the processes of regeneration and epithelization of wounds.

 As a prototype, a method for treating long-term non-healing wounds was selected, which consisted in applying dressings with ointments on a water-soluble basis (see Yu. R. Kashin et al. "Experience in the use of compositions of water-soluble ointments and paraffinized coatings in the treatment of IIIA degree burns." Materials of the VII All-Russian conferences on the problem of thermal lesions (Chelyabinsk, 1999, p. 175).

 However, the known method allows only to stop the inflammatory process in the wound in the first phase of the wound process and does not directly affect epithelization.

 The task of the invention is the activation of regenerative processes in the wound.

 The problem is solved due to the fact that in the method, including the application of dressings with water-soluble ointments, in the first phase of the wound process, aeroionotherapy sessions are carried out with an ion flux of 15 to 40 μA for 10-25 days, and in the second phase before applying dressings with with water-soluble ointments, a culture of allofibroblasts on a film matrix is transplanted onto the wound.

 A method for the treatment of nonhealing wounds is as follows. In the first phase of the wound process, after the toilet of the wound and the surrounding skin, aeroionotherapy sessions are carried out. The value of the ion flux is set in the range from 15 to 40 μA, depending on the nature of the wound process. Aeroionotherapy sessions are carried out for 10-25 days. After that, in the second phase of the wound healing process, allofibroblasts on a film matrix are transferred to the wound after its toilet and surrounding skin with antiseptic solutions, and a bandage with physiological saline is applied on top. After a day, the film matrix is removed and a bandage with ointments on a water-soluble basis (such as “levomekol”) is applied to the wound. Subsequent dressings are performed every other day. Aeroionotherapy sessions can be continued after the application of an allofibroblast culture to the wound.

 Clinical example. Zhikhareva A.F. 64 years old N 191744 was admitted to the NIIITO with a diagnosis of a long-term non-healing wound of the right lower leg after a mechanical injury, bronchial asthma. Local status: in the lower third of the right lower leg against the background of altered skin there is a wound 1.5 x 2 cm in size. The bottom of the wound is a flaccid, sclerotic, fibrin-coated granulation. The wound edges are scarred, signs of regional epithelization are not expressed. Cytologically: destroyed fibers, detritus, cellular elements are presented as single dystrophically altered neutrophils (dystrophic nature of the cellular reaction). The duration of the wound is 3 months. At the first stage of treatment, in order to cleanse the wound of necrotic tissue, stimulate microcirculation in the wound, a course of conservative therapy was carried out, including aeroionotherapy for 22 days. As a result of the treatment, the nature of the wound changed: granulation became juicy, bright, scanty, no plaque. Cytologically: detritus in a small amount, single fibers, cellular elements are represented by a large number of neutrophils of varying degrees of degradation and single polyblasts (3-5%), lymphocytes. In the second phase of the wound healing process, allogeneic fibroblasts on the film matrix are transplanted onto the wound surface, a dressing with a hydrocortisone solution is applied on top. The film from the surface of the wound was removed after 1 day, then the dressings were performed every other day with water-soluble ointments. On the 5th day after the transplantation of allofibroblasts, the size of the wound decreased to 0.5 x 1 cm, pronounced marginal epithelization is noted, the bottom of the wound is bright juicy granulation, there is no plaque, the discharge is scanty. Cytologically: cellular elements are abundant, the number of polyblasts increased by 10 times and amounts to 45-50%, neutrophils, lymphocytes, single macrophages, and detritus in a small amount (regenerative type of cellular reaction). Complete epithelization occurred 12 days after transplantation of allofibroblasts.

 The method allows to optimize the course of the wound process in all phases and provides complete healing of long-term healing wounds.

Claims (1)

 A method for treating nonhealing wounds by applying dressings with water-soluble ointments, characterized in that in the first phase of the wound process, aeroionotherapy sessions are carried out for 10-25 days, and in the second phase, cultures of allofibroblasts on the film matrix are transplanted before applying dressings with water-soluble ointments.