RU2192906C2 - Method for treating burn wounds - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves placing ultraviolet radiation source 1.5-2.0 m far from patient. Polymer Polysvetan film is positioned 15-20 cm far from the wound surface. Irradiation is carried out during 30-60 min daily. Power density flow is equal to 0.5-1.0 mW/m². The total daily treatment course is 10-14 days. EFFECT: enhanced effectiveness of treatment. 1 tbl

Description

 The proposed method relates to medicine and can be used in the treatment of patients with extensive burns of the II-IIIA degree.

 Traditional methods of treating wounds, including applying dressings with hypertonic and antiseptic solutions, ointments on hydrophilic or fatty bases, allow, basically, to optimally affect the wound process, but have a number of limitations or contraindications for use.

 Known methods of treating wounds using physical factors and effects. A special place in clinical practice is occupied by the stimulation of reparative processes in wounds by red light with a certain length of water.

 Methods based on the use of red light, most often using a helium-neon laser with different radiation power flux densities and different exposure exposures, can successfully treat wounds of various origins (6).

 However, laser equipment at the moment is complex and quite expensive, as well as having fairly specific sanitary and hygienic restrictions on its practical use (3; 4).

 Recently, researchers have been particularly interested in incoherent red light, which is completely harmless to both the patient and the doctor, more economically advantageous and not inferior in effectiveness to the laser (5).

 The closest in the set of essential features is a method of treating soft tissue wounds with red incoherent monochromatic light, which the authors selected as a prototype.

 The known method consists in the following: an incoherent monochromatized red light is applied to an object from a source with an aqueous length of 600-680 nm, a pulse repetition rate of 40-41 Hz, a flux power of 1.8-2.0 MW, for 15 minutes daily from a distance of 1 -2 mm (2).

 This method allows you to effectively treat postoperative long-term healing and burn wounds, as well as trophic ulcers. It is affordable and fairly simple in a clinical setting.

 However, the small area of the simultaneously irradiated surface is a significant inconvenience in the phototherapy of wounds that occupy large areas.

 The objective of the proposed method is to expand the arsenal of methods for treating burn wounds with a large area.

The problem is solved by a known method for treating burn wounds, including exposure to a wound with radiation of a wavelength of 600-620 nm, according to the invention, the effect is carried out by light from a source of ultraviolet radiation, previously passed through a polymer film located at a distance of 15-20 cm from the wound surface, which converts ultraviolet radiation into radiation with a wavelength of 600-620 nm, with a radiation power flux density of 0.5-1.0 mW / cm ² for 30-60 minutes daily.

As a polymer film take the film "Polysvetan", which is an environmentally friendly polyethylene, or polypropidene, or polyvinylchloride, or polycarbonate, and containing 0.001-5% wt. additives "f" of the formula Me Xm Yn-m Lk,
where Me is europium, samarium, terbium, dysprosium;
X, Y is the anion of monocarboxylic, benzylbenzoic or anitranidic acid, acetacetone, benzoidacetone, dibenzoylmethane or tenoyl trifluoroacetone;
L is the donor molecule;
n = 3 or 2, m = 0 or 1, k = 0, 1, 2, 3
Sunlight can also serve as a source of ultraviolet radiation.

 It is known that the Polysvetan film is capable of absorbing up to 99% of ultraviolet radiation with a wavelength of 340-380 nm, converting up to 80% of it into red radiation with a wavelength of 600-620 nm (1).

 The Polysvetan film is placed at a distance of 15-20 cm from the extensive wound surface.

The implementation of the proposed method with a flux density of radiation power of 0.5-1.0 mW / cm ^{2 is} optimal, because when the power flux density is less than 0.5 and more than 1.0 mW / cm ^{2 the} effectiveness of the therapeutic effect is reduced.

 The exposure time for the object within 30-60 minutes is also optimal, because more or less exposure time is less effective.

 Analysis of scientific, technical and patent information showed that the proposed method is new and meets the criterion of "inventive step".

The proposed method is as follows:
The patient is wearing light-protective glasses, intact parts of the body are covered with opaque material. A source of ultraviolet radiation, which can serve as a standard emitter of bactericidal OBN-150, is placed at a distance of 1.5 - 2.0 m from the patient. Radiation from a UV source (OBN-150 bactericidal lamp), passing through a photoconverting film, in particular the Polysvetan film, which is placed 15-20 cm from the wound surface, converts it into radiation with a wavelength of 600-620 nm (red light) . The power flux density is 0.5 - 1.0 mW / cm ² , the irradiation time is 30-60 minutes daily. The course of treatment is carried out for 10-14 days. The exposure time of the radiation to a large area burn wound is 30 minutes, and to a wound with signs of epithelization - 60 minutes.

 Monitoring the course of the process during treatment and after its completion is carried out by planimetric methods.

 The proposed method was treated 20 people with burns II-IIIA degree with a large burn surface area.

 The results of the treatment of patients with burns of the prototype and the proposed method are shown in the table.

 In addition, the table shows the results of treatment of the control group of patients treated with the traditional medication (control group) (see page 8).

 Examples of specific performance of the proposed method.

 Example 1

 Patient G., born in 1971, IB N167229 was admitted to the Republican Burn Center on August 16, 1995 with a diagnosis of Hot steam burn of the II-IIIA degree of the right foot in an area of 2% of the body surface. Conducted standard local and symptomatic treatment, regimen, diet, vitamin therapy. At the same time, before the dressings, the wound surface was irradiated from a source of ultraviolet radiation placed at a distance of 1.5 m from the patient. In this case, the radiation from the UV source was converted into radiation with a wavelength of 600-620 nm, passing through the Polysvetan photoconversion film located at a distance 15 cm from the wound surface. The exposure time of the radiation to the wound was 30 minutes with signs of epithelization of 60 minutes. The course of treatment was 12 days. The patient was discharged 08/28/95.

 Example 2

 Patient G. born in 1953 IB No. 167331 was admitted to the Republican Burn Center on 08/23/1995 with a diagnosis of II-IIIA gas burn of the left leg and foot degree on an area of 4% of the body surface. Conducted standard local and symptomatic treatment, regimen, diet, vitamin therapy. At the same time, before dressings, sunlight was irradiated through a Polysvetan-type photoconversion film for 60 minutes. Wounds epithelized on their own. Patient G. was discharged in satisfactory condition on September 7, 1995. The treatment period was 15 days.

 As can be seen from the data obtained, the proposed method proposes to treat burn wounds of the II-IIIA degrees rather effectively, allowing to reduce the hospitalization time compared to the control group in patients with burn wounds of the II-IIIA degree by 18-19 days, depending on the type of UV light source , and for 1-2 days compared with the prototype.

 As can be seen from the data obtained, the proposed treatment method is effective, harmless to patients and staff. As a source of UV radiation can be used standard sources of UV radiation, for example a bactericidal lamp OBN-150, or ordinary sunlight.

 The proposed method expands the arsenal of methods for treating wounds.

Sources of information
1. Golodkova L.N., Lepaev A.F., Dmitriev V.M., Zhavoronkov N.M. Ziskin G.D., Izmailov G.I., Schelokov R.N. Polymer composition // Description of the invention to author's certificate N 1381128 A1 of 03.15.88.

 2. The prototype. Grechko V.N. The effect of incoherent monochromatized red light on regenerative processes in soft tissue wounds. Abstract of thesis honey. Sciences, N. Novgorod, 1993, 18 pp.

 3. Zueva M.V., Ivanina T.A. The damaging effect of visible light on the retina in an experiment (electrophysiological and electron microscopic studies). // Vestn. Ophthalm.-1980.-N4-c. 48-50.

 4. Koshuba V. A., Kharlamovich S.Sh. The consequences of laser injury of various localization // Military Medic. Journal.-1986.-N7- p. 62-63.

 5. Novikov V. F., Potekhin P. P., Smirnov V. P. Histoanzymatic changes in tissues irradiated with a helium-neon laser and incoherent light. // Lasers and medicine - Abstracts. Tashkent, 1989-4.1-p.120.

 6. Tolstykh P.I., Ivanyan A.N., Gerasimova L.I., Derbenev V.A., Sopromadze M.A. Laser radiation in the treatment of patients with purulent-septic diseases and burns. M., 1994, 138c.

Claims (1)

 A method of treating burn wounds, comprising exposing the wound to radiation 600-620 nm long, characterized in that the exposure is effected by light from an ultraviolet radiation source that has previously passed through the Polysvetan polymer film located at a distance of 15-20 cm from the wound surface, for 30-60 minutes daily.

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