RU2311933C1 - Method for treating facial furuncles - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: it is necessary to fulfill ultrasound treatment of the wound with perfluoran twice or thrice per about 3060 sec. The it is important to apply a perfluoran-containing bandage for about 3-4 d. For the purpose to avoid drying of this bandage it is necessary to install there a thin catheter through which, by fractions, one should introduce perfluoran 3-4 times daily. The innovation accelerates the process of wound purification, improves tissue reparation due to efficient tissue oxygenation and, thus, develop a slightly visible cosmetic cicatrix.

EFFECT: higher efficiency of therapy.

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Description

The invention relates to medicine, namely to surgical dentistry, and can be used to treat facial boils.

There is a method of treating facial boils with ultrasound treatment of wounds with antiseptics, followed by dressing with Levomekol ointment (RF Patent No. 2180248 of 03/10/2002, IPC ⁷ A61N 5/067).

Disadvantages: antiseptics do not have oxygen transport and membrane-protective functions; when applying Levomekol ointment, as well as a solution of chlorhexedine, local allergic reactions are possible.

Effect: increase the effectiveness of the method, the prevention of allergic reactions.

These tasks are achieved by ultrasonic treatment of the wound with perfluorane, followed by dressing with perfluorane. To do this, use an ultrasound machine "Stomaton-1" (passport GKTE 945221.14.000.000 PS, 1996) and a domestic preparation from the group of emulsified fluorocarbons "Perftoran", which includes: perfluorodecalin - 15.2 g, perfluoromethylcyclohexylperedine - 7.6 g, proxanol-268 - 4.0 g and other elements. Perftoran is used as an anti-shock, anti-ischemic, and cardioprotective agent as a plasma substitute with a gas transport function mainly in cardiac surgery, transplantology and intensive care (F.F. Beloyartsev. Perfluorinated carbons in biology and medicine: collection of scientific papers, Pushchino, ONTI NTsBI AN SSSR USSR ; 1980 - C.5-21). For topical use, it is used for regional perfusion, lung lavage, washing purulent wounds of the abdominal and other cavities, in the treatment of burns, gunshot wounds, and for diabetic lesions of the extremities. No data were found on the treatment of facial boils with emulsion of perftoran in the literature.

The method is as follows. The patient is made an incision with a disposable scalpel after preliminary processing of the surgical field and the performed infiltration anesthesia. The resulting purulent exudate is evaporated and a necrolytic, mucolytic action is carried out by ultrasonic treatment of the wound (waveguide instrument "CE", "SJ", "SL"). Then, the same waveguides carry out the treatment of the wound with perfluoran emulsion, used for prolonged oxygenation of wound tissues using a pad moistened with a solution of perftoran 2-3 times per treatment course. Then a dressing with perfluorane is applied for 3-4 days to prevent the dressing from drying out, a thin catheter is placed in it, through which 0.5-0.6 ml of emulsion is introduced fractionally, 3-4 times a day.

The frequency of acoustic vibrations of the instrument waveguide (26.5 ± 1.0) kHz. The amplitude of the displacement of the working end of the waveguide of the instrument when it is loaded on air (40-60) microns, depending on the waveguide. The exposure of each procedure is from 30 to 60 seconds, depending on the area of the wound (1 minute per 1 cm of purulent wound). Ultrasonic treatment of the wound is carried out until it is completely cleaned. After cleansing the wound, secondary sutures are applied, or the epithelization of the wound goes under a dry crust.

Examples of specific performance.

Example 1. Shashkina G.V., born in 1967, and. No. 13569, was admitted to the clinic with a diagnosis of: Furuncle of the chin area on the left in the stage of abscess formation. During the first visit under an infiltration anesthesia with a solution of 1% novocaine, a disposable scalpel was cut, ultrasound treatment of the wound, perftoran using low-frequency ultrasound in the wound tissue, the exposure time was 30 seconds (wound surface area 0.65 cm ² ). Rubber drainage was introduced into the wound and a bandage with perfluorane was fixed, in which a catheter was installed to moisturize it 3 times a day. In the second visit, the patient notes an improvement in overall health, the absence of a pain symptom, normalization of body temperature to 36.6 ° C. Infiltrate decreased in diameter by 0.5 cm, became softer in consistency. Purulent exudate abundantly stands out from the wound, there are necrotic masses. Ultrasonic treatment of the wound, the introduction of perfluorane into the wound tissue using ultrasound through a technological pad. Changing the rubber drainage and applying a dressing with perfluorane and a fixed catheter in it to moisten the dressing 3 times a day. In the third visit, there is no soft tissue edema of the face, the scarce sacrificial discharge from the wound, there is no necrosis. Ultrasonic treatment of the wound and the introduction of ultrasound into the wound tissue of perftoran were performed. The edges of the wound are brought together, secondary sutures are made of polyamide 5/0. Sutures were removed on day 7, healing by first intention.

Example 2. Kostitsin A.A., born in 1986, and. No. 733709, turned to the clinic with complaints of pain and swelling in the area of the body of the lower jaw on the right, weakness, malaise, chills. From the anamnesis it was found that the swelling appeared 3 days ago after shaving with a razor. On examination, there is an infiltrate in the lower buccal region on the right with a size of 2.0 by 2.0 cm, the skin above it is swollen, hyperemic, and tense. In the center of the infiltrate, a purulent-necrotic core is determined. Diagnosed with Furuncle of the lower buccal region on the right in the stage of abscess formation. The treatment was carried out: an incision with a disposable scalpel was made under infiltration anesthesia, ultrasound treatment of the wound and the introduction of perftoran into the wound tissue using ultrasound, the exposure time of the procedure was 60 seconds (wound surface area 1.3 cm ² ). A rubber drainage was installed in the wound and a bandage with perftoran was applied, to prevent drying in which the catheter is fixed, the bandage was moistened 4 times a day. At the second visit, the patient does not show complaints, notes the absence of a pain symptom. Infiltrate in the buccal region on the right has become softer, decreased in size, collateral soft tissue edema is absent, profuse purulent exudate from the wound. Ultrasound treatment of the wound was carried out, ultrasound of perftoran was introduced into the wound tissue, drainage was changed, and a bandage with perftoran was applied, in which a catheter was installed to moisturize it 4 times a day. In the third visit, the patient has no complaints, with palpation tissue infiltration is not determined, from the wound, scarce sacred discharge. Ultrasonic treatment of the wound was carried out, ultrasound of perftoran was introduced into the wound tissue, then a bandage with a catheter was applied, which was moistened with perftoran 4 times a day. At the fourth visit, the patient has no complaints, edema is not determined, there is no discharge from the wound. Quenching the wound surface with a 1% alcohol solution of brilliant green.

Example 3. Pogodina TV, born in 1987, and. No. 35963, went to the clinic with complaints of pain and swelling in the lower lip. Notes the presence of weakness, malaise. From the anamnesis it was found that the swelling appeared 3 days ago. Previously noted the appearance of boils on other parts of the body over the past 2 years. On examination, there is an infiltrate in the region of the lower lip measuring 3.0 by 1.5 cm, the skin above it is swollen, hyperemic, tense, and a purulent-necrotic core is determined in the center of the infiltrate. Diagnosed with Furuncle of the lower lip in the stage of abscess formation. The treatment was carried out: under an infiltration anesthesia, an incision was made with a disposable scalpel, ultrasound treatment of the wound and its introduction into the wound tissue of perftoran, the exposure time of the procedure was 60 seconds (wound surface area 1.1 cm ² ). The wound is drained with a rubber band and a bandage is fixed with an emulsion of perftoran and a catheter inserted into it to moisturize 3 times a day. At the second visit, the patient does not show complaints, notes the absence of pain. Edema and infiltration of the tissues of the lower lip decreased significantly, purulent exudate from the wound. Ultrasound treatment of the wound and introduction of perfluorane into the wound tissue with ultrasound, drainage change and dressing with the same emulsion, which was moistened with a thin catheter 3 times a day. In the third visit, the patient does not complain, infiltrate measuring 1.0 by 0.5 cm, soft-elastic consistency, scarce sacred discharge from the wound. Ultrasound treatment of the wound, the introduction of perfluorane into the wound tissue using ultrasound, a bandage with a catheter was fixed, moistened with perfluorane 3 times a day. There are no complaints about the fourth visit, no swelling and soft tissue infiltration. Secondary surgical treatment of the wound, sutures polyamide 5/0. The sutures were removed on day 7, healing by primary intention with a delicate, inconspicuous scar.

The proposed method is used in the treatment of 27 patients with boils of the face of various localization. The results were obtained: the disappearance of complaints in patients was observed after 1.3 ± 0.6 days, body temperature returned to normal after 1.4 ± 0.8 days, improvement in overall well-being in patients was observed on 1.3 ± 0.72 days. When assessing the local course of the wound process, the following data were obtained: the disappearance of the pain symptom was observed at 1.31 ± 0.46 days, skin hyperemia around the wound after 1.7 ± 0.6 days, resorption of the infiltrate after 1.77 ± 0.57 days the duration of the exudation phase was 2.26 ± 0.71 days, the onset of granulation was observed at 3.15 ± 0.6 days. The duration of treatment of patients was 4.2 ± 1.24 days.

Positive effect: a method of treating facial boils by topical application of perfluorane in combination with low-frequency ultrasound allows for simultaneous surgery, physiotherapeutic effects on wound tissues, the introduction of a medicinal substance in the tissues that enhance their oxygenation, which causes a significant regression of the inflammatory process in 2-3 sessions, short-term wound cleansing and the formation of a subtle cosmetic scar. The method allows to save drugs and dressings, more economical and effective compared to the prototype.

Claims (1)

A method for treating facial boils with ultrasonic treatment of a wound with a drug and subsequent application of a dressing with a drug, characterized in that perftoran is used as a medicine for ultrasonic treatment, 2-3 times for 30-60 s depending on the area of the wound, which in addition, the dressing is fractionally moistened 3-4 times a day, the course of treatment is 3-4 days.