RU2558995C1 - Method of treating acute anal fissure - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: treating acute anal fissure involves introducing autoplasma in an amount of 2-2.5 ml under the fissure. That is preceded by 5-minute autoplasma barbotage with ozone-oxygen mixture.

EFFECT: method provides epithelising the anal fissure with minimum intraoperative injuries.

3 dwg, 1 ex

Description

The invention relates to medicine, in particular to a method for treating anal fissure.

A known treatment method using autoplasma containing platelets in high concentration (over 1,000,000). The method has found wide application primarily in dermatocosmetology (PP Akhmerov, R.F. Zarudiy, OI Korotkova, A.A. Vorobyov - “The use of platelet-containing autoplasma in dermatocosmetology and dentistry. Plasmolifting TM technology” - journal Plastic Surgery and cosmetology, 2013 (1), 1-192, pp. 94-104, 2013).

This method is based on the regenerative effect of platelet-rich plasma, which is injected into problem areas and activates the functioning of connective tissue cells. As a result, due to the body's own reserves, the biological mechanism of natural skin rejuvenation is launched without surgery and other cardinal measures. This technique is approved and registered by the Ministry of Health of Russia, is actively used in leading cosmetology clinics not only in our country, but also abroad. The use of autoplasma has found its application in maxillofacial surgery and dentistry (PP Akhmerov, R.F. Zarudiy, F.R. Akhmerov, M.V. Ovechkina, M.M. Zelyaev, O.I. Korotkova, A.A. Vorobyov - “A new method of stimulating tissue regeneration using platelet-rich plasma.” VIII-th Uzbekistan International Conference “Dentistry” Uzbekistan, Tashkent. P. 95. April 24-27, 2012).

Widely known and there are many publications on the use of ozone in various fields of medicine, including surgery. The positive effect of ozone is associated with the elimination of pain and swelling, a significant reduction in the duration of epithelization (in particular superficial burns), which is the subject of extensive domestic and foreign literature). In therapeutic concentrations, ozone has an immunomodulating, anti-inflammatory, bactericidal, fungicidal, analgesic effect. Ozone therapy in surgery is used in the treatment of general peritonitis, diffuse peritonitis, local peritonitis, purulent wounds of soft tissues, trophic ulcers, bedsores. The use of this method for acute anal fissures in the available literature we have not found.

Our experience. Used in ozone therapy in 5 patients with an acute anal fissure (10 ml of an ozone-oxygen mixture with a concentration of 3000 μg / l was punctured under the fissure 2 times a week. Used from 2 to 5 injections, on average - 3 injections in each patient. In 2 patients, healing of the crack began within 12 days, improvement in 1 patient and 2 effects were not.

There is a method of treating an anal fissure with alcohol-novocaine blockade according to Aminev, when 5 ml of a 1% solution of novocaine is injected into the pararectal fiber at the outer edge of the fissure, after 2-3 minutes the needle is advanced under the base of the fissure to a depth of 1 cm and 1 ml of 70% is injected alcohol (Fedorov V.D. et al. Clinical Operative Coloproctology, 1994, p. 333).

The disadvantage of this method is the short-term effect. According to literature, the disease resumes in 2-3 weeks.

This method is accepted by us as a prototype.

The objective of the proposed method is the epithelialization of the anal fissure due to the blockage of the anal fissure by the patient’s autoplasm, rich in platelets and saturated with ozone, which will allow to achieve a good long-term effect due to the minimum invasiveness of the intervention and the absence of terms for postoperative rehabilitation of patients.

The goal in the proposed method is achieved by the fact that autoplasma is bubbled with an ozone-oxygen mixture for 5 minutes, after which the autoplasma is introduced under the crack in a volume of 2-2.5 ml.

The proposed method and features that distinguish it from those known in the medical and patent literature are not found, which allows us to conclude that its criterion of "novelty" is met.

The essence of the proposed method is that autoplasma is bubbled with an ozone-oxygen mixture for 5 minutes, after which the autoplasma is introduced under the crack in a volume of 2-2.5 ml. A decrease in the volume of tissue removed in the perianal region in combination with intradermal cosmetic sutures leads to a decrease in pain, a reduction in the time of final recovery.

The method is illustrated by drawings:

in fig. 1 - centrifuge;

in fig. 2 - mono-council with Li-heparin and with a separation gel;

in fig. 3 - ozonizer.

The method is as follows: blood is taken from the patient's vein (8 ml). The latter is centrifuged (Fig. 1) in monowets with Li-heparin and with a separation gel (Fig. 2) for 5 minutes at a speed of 1700 rpm. In a 20 gram syringe, 2-2.5 ml of platelet-rich plasma is taken. Plasma is bubbled in the syringe with an ozone-oxygen mixture with a concentration of 3000 μg / l for 5 minutes (Fig. 3). Further, under local or caudal anesthesia, autoplasma in a volume of 2-2.5 ml is injected under the crack. In the presence of spasm of the sphincter of the anus, pneumo- or conical dilation is performed. The complex of subsequent treatment includes traditional methods of combating constipation, suppositories, thermal procedures, hygiene measures.

The proposed method is implemented in the presented clinical example:

 Patient V., 37 years old, was admitted with complaints of pain and the release of red blood during bowel movements. It hurts for about 2 weeks when, after a strong stool, the above complaints appeared. During external examination in the anus at 6 hours when diluting the edges of the anus there is a superficial mucosal defect 0.7 cm long with smooth edges and a soft bottom. With a manual examination - the sphincter tone is increased, at 6 hours - pain is noted. Diagnosed with acute posterior anal fissure.

Operation: under caudal anesthesia, immediately before the start of the operation, a dosed controlled anal canal divulsion was produced with a special cone-shaped device for 3 minutes. Blood is taken from the patient's vein (8 ml). The latter is centrifuged (Fig. 1) in a monowet with Li-heparin and with a separation gel (Fig. 2) for 5 minutes at a speed of 1700 rpm. In a 20 gram syringe, 2.3 ml of platelet-rich plasma is taken. Plasma is bubbled in the syringe with an ozone-oxygen mixture with a concentration of 3000 μg / l for 5 minutes (Fig. 3). Next, autoplasma in a volume of 2.3 ml is introduced under the crack. After 1 hour, the patient was released home. After 7 days, a similar intervention was performed according to the method described above. On the 13th day, the wound in the anal canal was epithelized.

A similar method treated 23 patients. The number of procedures for each patient ranged from 1 to 3, an average of 1.6 times. All patients after the first procedure noted the subsidence of pain during stool. Crack healing occurred in 16 patients in the period from 4 to 7 days, in 5 patients - up to 14 days and in 2 patients in the period up to 21 days. The study of autoplasma administered in all cases revealed a high (over 1,000,000) platelet count.

Claims (1)

A method of treating an acute anal fissure, characterized in that 2-2.5 ml of autoplasm enriched with platelets, pre-sparged with an ozone-oxygen mixture at a concentration of 3000 μg / l for 5 minutes are injected under the anal fissure.

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