RU2325198C1 - Face furuncles treatment method - Google Patents

Abstract

FIELD: medicine; surgery.

SUBSTANCE: suppurative focus is primary surgically treated with radio-wave surgery system "Dento-Surg". Incision is made with needle electrode at power 45-65 W. Necrotic suppurative core is removed with loop electrode at power 45-65 W. Wound is rinsed with perftoran emulsion. Perftoran emulsion bandage is applied, and wound is impacted with alternative magnetic field of frequency 50 Hz, magnetic induction 30 mTl. Impact time is 8-10 minutes. Sessions are carried out daily, 3-5 procedures per course.

EFFECT: decrease of treatment period for patients suffering from abscessing face furuncles.

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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 by treating a wound surface with a defocused beam of a high-energy carbon dioxide laser with a beam moving speed of 1 cm per second, with a surface radiation power density of 12.9 W / cm ² followed by suturing (RF Patent No. 2217184 of 01/08/2002 g IPC A61N 5/067).

Disadvantages: insufficient visual inspection and the lack of tactile contact of the laser beam with tissues does not allow to control the depth and area of exposure. Early suturing (1st visit) does not prevent the continuation of the inflammatory process and causes an extension of the treatment time for patients.

Effect: increasing the effectiveness of complex treatment of abscessed facial boils

These tasks are achieved by performing primary surgical treatment with the Dento-Surg radio wave apparatus (passport 08197515, 1991), followed by dialysis of the purulent wound with perftoran emulsion and magnetophoresis of this drug with the MAG-30 low-frequency portable device (passport TU 9444-003-1178130, 2003).

"Dento-Surg" is a small-sized mobile surgical multifunctional device. The method is based on the evaporation of water contained in cells under the influence of high-frequency radio waves that are emitted by a wire electrode. As a result, “evaporation” of cells directly in contact with the electrode occurs, thereby achieving less traumatic tissue splitting (Dubensky V.V. et al. Skin neoplasms in the practice of a dermatovenerologist // Tver, Triada, 2002, p.148). A characteristic feature of the radio wave is the narrow focus and lack of heating of the parallel layers of cells, which contributes to good wound healing (Brown J.S. Minor Surgery. New York, 1997).

Perftoran is a finely divided emulsion of fully fluorinated compounds (Ivanitsky G.R. Perftoran. // St. Petersburg, 2001, p. 4). The composition of the drug includes: perfluorodecalin - 15.2 g, perfluoromethylcyclohexylperedine - 7.6 g, proxanol-268 - 4.0 g and other elements. When applied locally, accelerated rejection of necrotic tissue and wound regeneration, increased functional activity of macrophages. The drug has been widely used in general surgery. The main method of administration is parenteral, but recently published data on the local use of perftoran. Local treatment in the form of dressings is used for long-term non-healing, infected wounds, burns, frostbite (Arkhipov V.V. et al., Organofluorine compounds in biology and medicine // Pushchino, 1999, p. 161-166).

MAG-30 - a magnetotherapy low-frequency portable apparatus. Magnetophoresis provides a joint therapeutic effect of an electromagnetic field and a drug. The magnetic field has an anti-inflammatory, anti-edematous effect, accelerates metabolic processes, improves microcirculation and trophic processes in tissues (Orzheshkovsky V.V. Clinical physiotherapy // Kiev "Health", 1984, p.83).

Data on the use of radio wave exposure, as well as dialysis of purulent wounds with perfluorane, followed by administration of the drug by magnetophoresis for abscessed facial boils in the literature were not found.

The method was carried out as follows: the primary surgical treatment of the purulent foci of the patient is carried out under local Sol anesthesia. Lidocaini 1% - 1-3 ml with a needle electrode of the Dento-Surg radio wave surgery apparatus in the “incision and coagulation” mode, with a power of 2-4 U (45-65 W). The purulent-necrotic rod is removed with a round or oval loop electrode in the “cut” mode at half (45-65 W) power. Wounds are washed with perftoran emulsion, drained with rubber strips, dressings impregnated with perftoran emulsion are applied. In order to stimulate regenerative processes the day after surgery, in the absence of contraindications, magnetophoresis is performed with the MAG-30 apparatus of perftoran emulsion. To do this, lay a sterile gauze cloth lavishly moistened with perfluorane on the surface of the purulent wound, and a dry gauze cloth is placed on top. The inductor is placed directly on a dry cloth without air gap. Use a low-frequency alternating electromagnetic field with a frequency of 50 Hz, with a magnetic induction of 30 mT. The mode is continuous half-cycle. The exposure was 8-10 minutes. The course of treatment was 3-4 procedures, daily for 1 procedure, until the complete cessation of exudation.

Example 1. Patient B., born in 1983, and. No. 520, was admitted to the dental clinic of the PHMA with a diagnosis of furuncle of the buccal region on the left in the stage of abscess formation. On the first visit under Sol anesthesia. Lidocaini 1% was cut with a needle electrode of the Dento-Surg apparatus in the “incision and coagulation” mode at a power of 2 PIECES (45 W). The purulent-necrotic rod was removed with a round loop electrode in the “cut” mode at half power. The wound was washed with perftoran emulsion, drained with a rubber strip, and a bandage soaked in perfluorane was fixed. In order to prevent the dressing from drying out and, consequently, the cessation of the drug, dressings and purulent wound dialysis were performed 2 times a day. On the second day, the patient noted an improvement in overall health, normalization of body temperature. Infiltrate in the buccal region on the left is not determined, collateral soft tissue edema is insignificant, scarce purulent exudate from the wound. The wound is washed with a solution of perftoran. A magnetophoresis session was performed by the apparatus MAG-30 of perftoran emulsion, the exposure time was 8 minutes, rubber drainage was introduced, and a bandage with perftoran was fixed. The third day: the patient does not complain, the tissue infiltration is absent, the blood flow is removed from the wound, and granulations are visible at the bottom. The wound was washed with a solution of perftoran, a session of magnetophoresis was carried out for 10 minutes, an ointment dressing was applied (ointment "levomekol"). The fourth day after surgery: there is no discharge from the wound, the wound is filled with granulation tissue, after medical manipulations the patient was discharged for outpatient treatment.

Example No. 2. Patient E., born in 1964, and.b. No. 51051, went to the clinic with complaints of pain and swelling in the lower lip, weakness, malaise. On examination, the infiltrate in the region of the lower lip is determined to be 1.5-1.5 cm, the skin in this area is swollen, hyperemic, and tense. In the center of the infiltrate purulent-necrotic core. Diagnosed with a boil in the lower lip in the stage of abscess formation. The treatment was carried out: an incision was made under the radio wave apparatus under infiltration anesthesia, the purulent-necrotic rod was removed with an oval electrode, the wound was washed with perfluorane, drained, and a bandage with perftoran emulsion. The purulent wound was dialyzed and the dressings were changed 2 times a day. At the second visit, the patient does not complain, notes an improvement in general condition. Tissue infiltration is insignificant (0.5 cm in diameter), collateral soft tissue edema is absent, scant purulent exudate from the wound. The wound was washed with perftoran, a magnetophoresis session with this drug was carried out, drainage was changed, and a bandage with perftoran was carried out. In the third visit, there is no tissue infiltration, from the wound there is a blood discharge. The wound is washed with an emulsion of perftoran, a session of magnetophoresis, ointment dressing. On the fourth visit, there is no discharge from the wound. The wound surface is treated with a 1% alcohol solution of brilliant green. The patient was discharged with recovery. Inspection 2 months after the treatment. The scar is inconspicuous, smooth, the same color as the skin.

Example No. 3. Patient S., born in 1971, and. No. 831, turned to the PGMA dental clinic with complaints of pain and swelling in the temporal region on the right. On examination, infiltration is determined in the temporal region on the right with a length of 2.0-2.0 cm, the skin in this area is swollen, hyperemic, and tense. In the center of the infiltrate purulent-necrotic core. The diagnosis was established: a boil in the temporal region on the right in the stage of abscess formation. Under infiltration anesthesia, a 2.0-cm incision was made with a needle electrode of the Dento-Surg apparatus in the “incision and coagulation” mode, the source power was 3 units (45 W). The purulent-necrotic rod was removed with a round electrode of this apparatus in the "cut" mode, the power of the source is 4 PIECES (50 W). The wound was washed with an emulsion of perftoran, introduced rubber drainage, a bandage with this drug. Dialysis and changing dressings was carried out 2 times a day. On the second day, the patient did not show complaints, noted the absence of a pain symptom. Edema in the temporal region on the right is insignificant, tissue infiltration is not determined, purulent exudate from the wound. The wound was washed with perfluorane, carried out magnetophoresis of this drug and a change in drainage. Dressing with perftoran emulsion. On the third day from the wound, anemic discharge. Perftoran was introduced into the wound tissue using the MAG-30 apparatus, a dressing with “levomekol” ointment. On the fourth day, the patient was discharged from the hospital for outpatient treatment.

The proposed method was used in the treatment of 20 patients with facial boils in the stage of abscess formation.

Positive effect: the use of radio wave technology, purulent wound dialysis and magnetophoresis with perftoran emulsion is effective in the complex treatment of patients with abscessed facial boils.

The radio wave method allows high-quality primary surgical treatment of the purulent lesion, since in all cases observed, the radio wave incision does not require effort, is accurate, forms flat wound edges and is accompanied by simultaneous coagulation of skin and subcutaneous small vessels, which leads to an almost “dry” surgical field. Created time savings during the manipulation while maintaining good visual control of the wound.

Perftoran emulsion quickly stops the inflammatory process and stimulates regenerative processes in the wound, which allows to reduce treatment time by 2-3 days, avoid complications and achieve a good cosmetic result. The proposed method allows to reduce the time of the operation; the number of hospital days spent by patients in the hospital, and the time of disability; reduce the consumption of drugs and dressings, therefore, this method is more economical and effective compared to the prototype.

Claims (1)

A method for the treatment of facial boils, including primary surgical treatment of the purulent lesion followed by hardware treatment of the wound surface, characterized in that the primary surgical treatment of the purulent lesion is performed by the Dento-Surg radio wave surgery apparatus, the incision being made with a needle electrode at a power of 45-65 W, and purulent-necrotic rod is removed with a loop electrode at a power of 45-65 W, the wound is washed with perfluoran emulsion, a dressing impregnated with perftoran emulsion is applied, then a magnet is carried out phoresis emulsion perfluorane frequency of 50 Hz, magnetic flux density of 30 mT, for 8-10 minutes, daily, a course of 3-4 treatments.