RU2524191C1 - Method for making drain tube for treating pyoinflammatory diseases of dentofacial soft tissues - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: Coletex-M tissues are stripped and tape is made of polyethylene or rubber. The tissue strips and tape are overlapped and cut out after a wound configuration and size. The cut out tape is uniformly coated with a preparation of hyaluronic acid or Levomekol up to 1 mm. The tissue strips are applied on the tape with the preparation to form a plate. The plate is duplicated at the length S. Scissors are used to cut down a portion of the plate within the fold from the fold at an angle of 45°.

EFFECT: method enables just making the drain tube providing adequate drainage of a dentofacial pus pocket, reduces a risk of thrombosing of the drain tube, minimises injuries of the wound edges, provides a wide spectrum of antiseptic and antibacterial activity of the drain tube, ensures an immunopotentiating effect, active diffusion of pharmaceutical compositions.

4 ex, 3 dwg

Description

The invention relates to medicine, namely to surgical dentistry and maxillofacial surgery, and is intended for the treatment of purulent-inflammatory diseases of the soft tissues of the maxillofacial region.

A known method of manufacturing drainage for drainage of purulent wounds, which consists in using gauze as a drainage material, is preliminarily saturated with gauze with antiseptic solutions, hypertonic (10%) sodium chloride solution [1].

The disadvantage of this method is that the manufactured drainage by the end of the first day is thrombosed, impregnated with purulent exudate and dries within 4-6 hours, does not provide adequate drainage of the purulent cavities, the use of this method of manufacturing drainage leads to additional dressings, when the granulation sprouts into the resulting drainage upon extraction, additional trauma to the edges of the wound, accompanied by intoxication, is possible, does not provide a wide range of antiseptic and antibacterial activity, immunost Muliro effect.

A known method of manufacturing drainage for drainage of purulent wounds, which consists in using silicone, rubber, PVC tubes of a certain diameter as a drainage material, makes several holes at the end of the tube to be immersed in the wound, the end of the tube is obliquely cut, the sharp edges are rounded. Holes on the lateral surfaces of the drainage are applied during surgery in accordance with the size and configuration of the wound cavity [1, 2].

The disadvantage of this method is that the manufactured drainage is thrombosed, does not provide adequate drainage of the purulent cavities, the use of this method of manufacturing drainage leads to additional dressings, when granulation sprouts into the resulting drainage during extraction, additional injury to the edges of the wound accompanied by intoxication is possible, the manufactured drainage can cause pressure sores surrounding tissues and vascular injury, does not have pharmacological properties.

A known method of manufacturing drainage for drainage of purulent wounds, which consists in using cotton, letilan-lavsan, polyethylene, rubber, silicone strips (tapes), glove rubber strips as a material for drainage. Linear strips are pre-cut during surgery in accordance with the size of the wound [3].

The disadvantage of this method is that the manufactured drainage contributes to the subsidence of the wound edges, does not provide adequate drainage of purulent cavities, the use of this method of manufacturing drainage leads to additional dressings, does not have antiseptic and antibacterial properties, and an immunostimulating effect.

A known method of manufacturing drainage for drainage of purulent wounds, consisting of the following steps. Cut strips of napkins "Coletex-M" 10 mm wide, 35 mm long. Reinforced in two rows with U-shaped seams from synthetic non-absorbable threads to give a corrugated shape up to 25 mm long [4].

The disadvantage of this method is that the manufactured drainage contributes to the subsidence of the wound edges, does not provide adequate drainage of purulent cavities, the use of this method of manufacturing drainage leads to additional dressings, the method has a difficulty in manufacturing, does not provide a wide range of antiseptic and antibacterial activity, immunostimulating effect, and active diffusion of pharmaceutical compositions from napkins.

This method is taken as a prototype.

The aim of the invention is the simplicity of the manufacture of drainage, providing adequate drainage of purulent cavities, reducing the number of dressings and the risk of thrombosis, minimizing injury to the edges of the wound when removing manufactured drainage, providing a wide range of antiseptic and antibacterial activity of the drainage, immunostimulating effect, creating active diffusion of pharmaceutical drainage compositions.

This goal is achieved by the fact that strips of Koleteks-M napkins and a tape are laid on top of each other and cut at the same time according to the template with individual sizes depending on the configuration and size of the wound; preparations based on hyaluronic acid or Levomekol are applied to the cut tape with a spatula, evenly distributing on the surface with a thickness of up to 1 mm; strips of Koleteks-M napkins are laid on a tape with a preparation based on hyaluronic acid or Levomekol until the edges along the perimeter coincide with the formation of a plate; the plate is folded with duplicate ½ length, tape to each other with the formation of two free ends; in the area of the bend of the plate with the help of scissors, the plate is cut from the edge of the bend angle at an angle of 45 ° with respect to the edge of the bend.

A method of manufacturing a drainage for drainage of purulent wounds in the treatment of purulent-inflammatory diseases of the soft tissues of the maxillofacial region is used as follows. After opening the purulent foci, the wound is washed with antiseptic solutions, strips of Koleteks-M napkins and a tape of letilan-lavsan, or polyethylene, or rubber, or silicone, or glove rubber, are laid on top of each other and cut simultaneously according to a template with individual sizes depending on the configuration and size of the wound; Hyaluronic acid or Levomekol-based preparations are applied to the cut tape with a spatula, evenly distributing up to 1 mm thick on the surface, and strips of Koleteks-M napkins are laid on the tape with the hyaluronic acid-based or Levomekol preparation until the edges around the perimeter form a plate , the plate is folded with duplicate ½ length, tape to each other with the formation of two free ends, in the area of the bend of the plate using scissors, the plate is cut from the edge of the bend angle 45 ° with respect to the inflection edge.

A method of manufacturing a drainage for drainage of purulent wounds in the treatment of purulent-inflammatory diseases of the soft tissues of the maxillofacial region is illustrated by graphic material.

Figure 1 shows the strips (1) of Koleteks-M napkins, laid on a tape (2) of letilan-lavsan, or polyethylene, or rubber, or silicone, or glove rubber, coated with a hyaluronic-based preparation (3) acid or Levomekol uniformly distributed on the surface with a thickness of up to 1 mm, until the edges coincide along the perimeter with the formation of a plate (4).

In figure 2, the plate (4) is folded with duplicate ½ length, tape (2) to each other with the formation of two free ends (5) and bend (6) of the plate (4).

Figure 3, a side view, in the area of the bend (6) of the plate (4) using scissors made a cut (9) of the plate from the edge of the angle of the bend (7) at an angle of 45 ° relative to the edge of the bend (8).

Using the new method and the results of its application are confirmed by examples.

The method is represented by the following examples.

Clinical example 1. Patient N., 31 years old. Diagnosis - Acute purulent odontogenic periostitis of the lower jaw on the right. The patient underwent surgery - opening an abscess, tooth extraction 4.4. Under local anesthesia of Sol.Lidocaini 2% -4.0 ml, tooth extraction was performed using cob-shaped forceps 4.4. An incision was made in the projection of teeth 4.3, 4.4, 4.5, retreating 0.5 cm from the transitional fold of the lower jaw. The mucous membrane, submucosal layer, periosteum were dissected, stupidly passed into the abscess cavity, 3 ml of liquid pus was obtained. The wound is washed with antiseptic solutions. Two strips of Koleteks-M napkins and a glove of glove rubber are superimposed on each other and cut at the same time according to a pattern with individual sizes (length 4 cm, width 1 cm). A hyaluronic acid-based preparation “Hyaludent” is applied to the cut ribbon with a spatula, evenly distributed on a surface up to 1 mm thick, strips of “Coletex-M” napkins are laid on a tape with the applied preparation based on hyaluronic acid “Hyaludent” until the edges along the perimeter coincide with the formation of the plate, the plate is folded by duplicate ½ length, tape to each other with the formation of two free ends; in the area of the bend of the plate with the help of scissors, the plate was cut from the edge of the bend angle at an angle of 45 ° with respect to the edge of the bend. Drainage was introduced into the wound. Drainage was replaced daily. On day 2, there was no discharge from the wound. On the 2nd day, drainage was removed from the wound. Epithelization on the 8th day.

Clinical example 2. Patient S., 28 years old. Diagnosis - Acute purulent odontogenic periostitis of the upper jaw on the left. The patient underwent surgery - opening an abscess, tooth extraction 2.5. Under local anesthesia of Sol.Lidocaini 2% -4.0 ml, a tooth extraction was performed using forceps 2.5. An incision was made in the projection of teeth 2.4, 2.5, 2.6, retreating 0.5 cm from the transitional fold of the upper jaw. The mucous membrane, submucosal layer, periosteum were dissected, stupidly passed into the abscess cavity, 3 ml of liquid pus was obtained. The wound is washed with antiseptic solutions. Two strips of Koleteks-M napkins and a tape of letilan-lavsan are superimposed and cut at the same time according to a pattern with individual sizes (length 4 cm, width 1 cm). Hyaluronic acid-based preparation based on hyaluronic acid is applied to the cut ribbon with a spatula, it is evenly distributed on the surface with a thickness of up to 1 mm, strips of Koleteks-M napkins are laid on the ribbon coated with Hyaluronic acid-based preparation until the edges along the perimeter coincide with the formation of the plate, the plate is folded by duplicate ½ length, tape to each other with the formation of two free ends; in the area of the bend of the plate with the help of scissors, the plate was cut from the edge of the bend angle at an angle of 45 ° with respect to the edge of the bend. Drainage was introduced into the wound. Drainage was replaced daily. On day 2, there was no discharge from the wound. On the 2nd day, drainage was removed from the wound. Epithelization on the 8th day.

Clinical example 3. Patient K., 45 years old. Diagnosis - Odontogenic phlegmon of the infratemporal fossa on the right. The patient underwent surgery - opening the phlegmon. Under local anesthesia, an incision was made in anticipation of the oral cavity along the transitional fold of the upper jaw on the left in the projection of 1.6-1.8 teeth. The mucous, submucous layer is dissected. Stupidly passed into the pterygopalatine fossa on the right. Received pus in a volume of 6 ml. Hemostasis. The wound is washed with antiseptic solutions. Three strips of Koleteks-M napkins and a silicone tape are superimposed and cut at the same time according to a pattern with individual sizes (length 4 cm, width 1 cm). Hyaluronic acid-based preparation based on hyaluronic acid is applied to the cut ribbon with a spatula, it is evenly distributed on the surface with a thickness of up to 1 mm, strips of Koleteks-M napkins are laid on the ribbon coated with Hyaluronic acid-based preparation until the edges along the perimeter coincide with the formation of the plate, the plate is folded by duplicate ½ length, tape to each other with the formation of two free ends; in the area of the bend of the plate with the help of scissors, the plate was cut from the edge of the bend angle at an angle of 45 ° with respect to the edge of the bend. Drainage was introduced into the wound. An aseptic dressing is applied. The formation of granulations on the 7th day.

Clinical example 4. Patient U., 22 years old. Diagnosis - Odontogenic phlegmon of the submandibular region on the right. The patient underwent surgery - opening the phlegmon. Under intravenous anesthesia, an incision was made in the submandibular region to the right parallel to the marginal branch of the facial nerve, 2 cm from the edge of the lower jaw. The skin, subcutaneous fat, the superficial fascia of the neck, and subcutaneous muscle were dissected. Taken to the ligature and crossed the facial vein. Stupidly passed into the submandibular region. Received pus in a volume of 8 ml. Hemostasis. The wound is washed with antiseptic solutions. Three strips of Koleteks-M napkins and a tape made of rubber are laid on each other and cut at the same time according to a pattern with individual sizes (length 4 cm, width 1 cm). The Levomekol preparation is applied to the cut tape with a spatula, evenly distributed on the surface with a thickness of up to 1 mm, strips of Koleteks-M napkins are laid on the tape with the Levomekol preparation until the edges coincide with the formation of the plate, the plate is folded by duplicate ½ length, the tape is different to a friend with the formation of two free ends; in the area of the bend of the plate with the help of scissors, the plate was cut from the edge of the bend angle at an angle of 45 ° with respect to the edge of the bend. Drainage was introduced into the wound. An aseptic dressing is applied. The formation of granulations on the 10th day.

Clinical example 5. Patient S., 18 years old. Diagnosis - Abscessing boil of the buccal region on the right. The patient underwent surgery - opening an abscess. Under local anesthesia, Sol.Lidocaini 2% -4.0 ml dissected the skin, subcutaneous fat, stupidly passed into the abscess cavity, received 2 ml of liquid pus. The wound is washed with antiseptic solutions. Two strips of Koleteks-M napkins and a polyethylene tape are superimposed and cut at the same time according to a pattern with individual sizes (length 4 cm, width 1 cm). Hyaluronic acid-based preparation based on hyaluronic acid is applied to the cut ribbon with a spatula, it is evenly distributed on the surface with a thickness of up to 1 mm, strips of Koleteks-M napkins are laid on the ribbon coated with Hyaluronic acid-based preparation until the edges along the perimeter coincide with the formation of the plate, the plate is folded by duplicate ½ length, tape to each other with the formation of two free ends; in the area of the bend of the plate with the help of scissors, the plate was cut from the edge of the bend angle at an angle of 45 ° with respect to the edge of the bend. Drainage was introduced into the wound. Drainage was replaced daily. On day 3 there was no discharge from the wound. On the 3rd day, drainage was removed from the wound. The formation of granulations on the 9th day.

The positive effect of using the proposed method is expressed in that it allows you to simply make a drain that provides adequate drainage of purulent cavities, reduces the number of dressings and the risk of thrombosis of the made drainage, minimizes trauma to the edges of the wound when removing the made drainage, and provides a wide range of antiseptic and antibacterial activity of the drainage, immunostimulating effect, active diffusion of pharmaceutical compositions of the obtained drainage. The proposed model can be used in the departments of maxillofacial surgery and outpatient dental institutions.

INFORMATION SOURCES

1. Kosinets A.N., Struchkov Yu.V. Infection in Surgery: A Guide. - Vitebsk: Voronezh State Medical University, 2004 .-- P.85.

2. Gulman M.I., Vinnik Yu.S., Miller S.V., Karapetyan G.E. Atlas of drainage in surgery. - Krasnoyarsk, 2004 .-- 76 s - 10.

3. Kravchenko V.V., Leshchenko I.G. Diagnosis and treatment of purulent dental infection: Monograph. - Samara: State Enterprise “Perspective”, 2003. - p.28.

4. RF patent No. 2009133727/14, А61В 17/00, Fedotov Stanislav Nikolaevich (RU), Sukhanov Anton Evgenievich (RU), Sukhanov Konstantin Evgenievich (RU) dated 04/13/2009.

Claims (1)

A method of manufacturing drainage for draining purulent wounds in the treatment of purulent-inflammatory diseases of the soft tissues of the maxillofacial region, including cutting strips from Koleteks-M napkins and tapes of a similar size from letilan-lavsan, or polyethylene, or rubber, or silicone, or glove rubber; characterized in that the strips of Koleteks-M napkins and the tape are laid on top of each other and cut simultaneously according to the template with individual sizes depending on the configuration and size of the wound; preparations based on hyaluronic acid or Levomekol are applied to the cut tape with a spatula, evenly distributing on the surface with a thickness of up to 1 mm; strips of Koleteks-M napkins are laid on a tape with a preparation based on hyaluronic acid or Levomekol until the edges along the perimeter coincide with the formation of a plate; the plate is folded with duplicate ½ length, tape to each other with the formation of two free ends; in the area of the bend of the plate with the help of scissors, the plate is cut from the edge of the bend angle at an angle of 45 ° with respect to the edge of the bend.

Images