RU2477999C1 - Method for prevention of burn deepening in paranecrotic areas - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly combustiology and may be used for prevention of burn deepening in a paranecrotic area. That is ensured by liquid nitrogen spraying over the burn surface to observe white frost and wound surface temperature reduction to 5°C; 10 minutes later, a therapeutic mixture of Tisol gel and 20% Actovegin gel 1:1 is applied in the form of a layer 1-2 mm. The burn surface is covered with a moistened dressing with an aqueous solution of antiseptic.

EFFECT: method makes it possible to eliminate a hyperthermic factor in the wound depth, to improve microcirculation, to provide a bactericidal effect and to enhance tissue oxygenation in the paranecrotic area.

1 ex

Description

The present invention relates to medicine, in particular to combustiology, and can be used to prevent deepening of burns in the paranecrotic zone.

A burn wound is not a “stable” formation and its deepening is possible due to circulatory disorders and, first of all, with capillary stasis, causing tissue anoxia first and then their necrosis. Particularly favorable conditions for persistent stasis, and sometimes thrombosis of large vascular branches, are created with circular burns of the limbs. As a result of the action of the thermal agent on the skin and subsequent vascular disorders in the burn wound zone, leading to the initiation of secondary alteration processes, cell death occurs in the paranecrotic zone and a large amount of endogenous heat is released. In this case, the temperature of the surrounding tissues rises to 70 ° C and higher, which leads to a secondary deepening of the wound. A so-called hyperthermic factor is formed, which within several days causes the death of the growth layer of the epidermis and epithelial appendages of the skin. The risk of generalization of the infection increases, the prognosis and results of treatment of thermal injury are significantly worsened.

As a prototype, a method was selected that includes applying dressings to the burned surface moistened with chilled solutions of antiseptics and replacing them every 10-15 minutes as they are heated or irrigated with chilled aqueous solutions of antiseptics (see “Burns.” Manual for doctors, ed. B S.S.Vikhrieva, V.M. Burmistrova. - L .: Medicine, 1986, p.132-133).

However, the known method is quite time-consuming, requires constant involvement of medical staff, does not ensure wound sterility, does not significantly eliminate the hyperthermic factor in the deep layers of the wound, is accompanied by soreness when changing dressings, does not affect tissue oxygenation and improve microcirculation in the paranecrotic zone.

The task of the invention is to improve the method.

The technical result is the elimination of the hyperthermic factor, the improvement of microcirculation in the paranecrotic zone of the burn wound, the provision of bactericidal activity and increased tissue oxygenation.

The technical result is achieved due to the fact that in a method that involves applying a moistened dressing to an burned surface with an aqueous solution of an antiseptic, liquid nitrogen in a vapor-liquid state is sprayed before it is applied to the wound at a distance of 10-15 cm until frost appears and decreases burn scab temperatures up to 5 ° C, and a medicinal mixture of Tizol gel and 20% Actovegin gel is applied in a ratio of 1: 1 with a layer of 1-2 mm.

A method for the prevention of deepening of burn wounds in the paranecrotic zone is as follows: when a patient with a thermal injury arrives in a hospital on a burn surface of any area, liquid nitrogen is sprayed in a vapor-liquid state until frost appears on it and the temperature of the burn scab is reduced to 5 ° C, under the control of an infrared thermometer CEM Thermo Diagnostics (certificate No. POCC RU. ME96.H00017. When spraying, the spray nozzle is placed at a distance of 10-15 cm from the burn surface. Spray time 20-30 s 10 minutes after spraying liquid nitrogen, a medicinal mixture of Tizol gel and 20% Actovegin gel in a 1: 1 ratio is applied 1–1 mm thick for 2 days, the burn surface is covered with a wet-drying dressing with water a solution of an antiseptic, such as chlorhexidine.

Clinical example: B-naya M., 2 years 7 months (IB No. 252595), was admitted to the burn center of NNIITO on February 23, 2011 with a diagnosis of boiling water of 1-P-ShAB degree of the right upper, both lower limbs and perineum on an area of 10% of the body surface. Upon admission to the child in order to eliminate the endogenous hyperthermic factor, and to ensure bactericidal activity, liquid nitrogen was applied to the burned surface with a spray gun until frost appeared. The temperature of the burn scab was determined by an infrared thermometer CEM Thermo Diagnostics and amounted to 5 ° C. Along with this, the microcirculatory blood flow of the wound surface was measured with the LAKK-02 instrument before spraying liquid nitrogen, 10 minutes after spraying and one hour after applying the drug composition. The microcirculation indicators before spraying liquid nitrogen amounted to 16.32 conventional units, after 10 minutes - 4.07 conventional units. After spraying liquid nitrogen onto the burned surface, a medicinal mixture of Tizol gel and 20% Actovegin gel is applied in a ratio of 1: 1 1-2 mm thick, then the burn surface is covered with a wet-drying dressing with an aqueous solution of chlorhexidine. Microcirculation an hour after application of the drug mixture amounted to 38.52 conventional units, which indicates an improvement in blood flow in the area of burn wounds. Dermal burns healed within 10 days without deepening the wound surface. The patient was discharged March 16, 2011 after recovery.

A method for the prevention of deepening of burn wounds in the paranecrotic zone allows you to eliminate the hyperthermic factor deep in the wound, improve microcirculation in the paranecrotic zone, provides bactericidal activity and increases tissue oxygenation.

Claims (1)

A method for preventing deepening of burns in the paranecrotic zone, comprising applying to the burned surface a moistened dressing with an aqueous solution of an antiseptic, characterized in that before applying it to the wound at a distance of 10-15 cm from the wound, liquid nitrogen is sprayed in a vapor-liquid state until it appears on it frost and reduce the temperature of the burn scab to 5 ° C and impose a medicinal mixture of Tizol gel and 20% Actovegin gel in a ratio of 1: 1 with a layer of 1-2 mm.