RU2619876C1 - Method for skin wounds treatment with radiation in infrared wavelength range - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: cancellous bone projections containing bone marrow, and skin wound at the site of injury are daily exposed to radiation in the infrared wavelength range. Cancellous bone projections in the sacrum and iliac bones area are irradiated for 1 to 2 minutes per each area. The skin wound is irradiated in a scanning mode at a distance of 0.3-0.5 cm from the body surface for at least 1 minute. Infrared laser radiation with a wavelength of 980 nm, power of 0.5 W, power density of 500 mW/cm² is applied. Each ares is exposed once a day, for 3-5 days. For skin wounds, undergoing surgery, irradiation of cancellous bone and skin wound projections at the site of injury starts respectively on the first and the second day after surgery. For skin wounds, not undergoing surgery, irradiation of cancellous bone and skin wound projections at the site of injury starts respectively on the first and the second day after skin wound occurrence.

EFFECT: increased efficiency of skin wounds treatment due to hematopoiesis, nonspecific immunity stimulation, enhanced stem cells concentration in blood, improved microcirculation and repair in the tissue defect area.

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Description

The invention relates to methods for treating skin wounds, in particular in surgery, including experimental surgery, plastic surgery, cosmetology, and can be widely used in the treatment of skin surgical wounds, in particular when removing skin tumors, treating burns and plastic surgery .

A known method of treating skin wounds by exposure to a monochromatized light flux in the red wavelength range in a pulsed mode with rectangular pulses, which consists in exposure to a wavelength of 600-690 nm, a pulse repetition rate of 40 41 Hz, a duration of 12-13 ms, a power density of 5- 10 W / cm ² for 15-20 minutes daily for 6 days (see patent No. 2032432, M. C. A61N 5/06, publ. 04/10/1995).

However, the known method provides efficacy in the treatment of only surgical skin wounds and ulcers and is not effective in the treatment of burn wounds.

An experimental study is known to study the effect of laser radiation with a wavelength of 0.63 μm and an output power of 13 mW / cm ² on experimental damage (wound) on the right side surface of the body of outbred white rats weighing from 100 to 150 grams. An LG-111 helium-neon-based apparatus was used as a laser radiation source. Irradiation was carried out 2 times a week for 10 minutes. The diameter of the focused spot was on average 1.0 cm (see the article in the journal “Bulletin of New Medical Technologies”, 2012, vol. XIX, No. 2, p. 316, https://docviewer.yandex.ru/print.xml? uid = 0 & sk = 7b315cb00c7931a0ca068bc5af09aca8 & id = 1d7puh7csnjg08ie3e3wgsxrzz42nq6x0u0v07ntqshnq4g5usinc31x1rqt76oagj5hec6v7pcjx4h4b4w7rs3a4b4rs2

The results of this study showed that the regenerative processes in a cut wound of the skin under the influence of laser radiation go through all the classical stages, however, the duration of each of them is significantly reduced. So, by the 5th day after the operation after exposure to the skin wound with laser radiation, a typical picture of acute exudative inflammation is observed. By 10 days, connective tissue begins to form in the area of the future scar: in the adjacent zone, a clear picture of actively regenerating connective tissue and nearby muscles. On the 15th day after irradiation of the LLLT wound, a picture of the most intense capillary neoplasm is observed. By 30 days when irradiating a skin wound, the LILI picture resembles, in general, developed connective tissue.

This known method is quite long.

A known method of treating skin wounds, selected as the closest analogue, which consists in irradiating a skin wound with radiation in the infrared wavelength range, including irradiating the sternum for 10-15 minutes and the lesion (wound) from 20 to 40 minutes 2-3 times per day, only 6-8 days. Irradiation is carried out in the fields, capturing the entire wound surface and healthy tissue within 1-1.5 cm and moving from the periphery to the center of the wound (see http://www.geska.ru/specification/spec_12.htm#perelom).

Irradiation in the known method is carried out using the apparatus of the Hesca series, designed for non-invasive combined exposure to electromagnetic radiation on the pathological focus or the body as a whole by irradiation of reflexogenic zones, biologically active points of the patient.

For the treatment of skin wounds by a known method, the following technical characteristics of the device are used:

wavelength: nm

- infrared 840-950;

radiation power density, mW / cm ² :

From 2.0 to 10 at a wavelength of 840-950 nm,

Magnetic induction, MT: 10

The irradiation area cm ² , not less than: 220 ± 10.

The treatment of skin wounds by a known method is as follows: the device is plugged into a power outlet with a voltage of 220 V, frequency 50 Hz. Using the push-button switch, the necessary mode for the procedure is set:

- for stopping acute inflammation - blue light with infrared radiation;

- for the treatment of diseases - red with infrared radiation.

The luminous flux is induced on the affected area (ulcers, wounds, pain points) or on the corresponding reflexogenic zones, on the projection of the main blood vessels, on the projection of the internal organs. To increase the efficiency, the irradiator is periodically moved parallel to the irradiation plane at a speed of 1 cm / sec. If the lesion focus exceeds the size of the light beam, then irradiation is carried out by moving the device in a spiral from the periphery of the focus to its center.

Using a well-known technique, it is possible to treat bandaged surfaces, but with slightly less effectiveness.

The depth of exposure to radiation by a known method is 5-7 cm. A further increase in the duration of the procedure will not cause the patient any harm, but will not increase the effectiveness of the effect. Simultaneous exposure to the same part of the body of LED radiation and the magnetic field significantly increases the preventive and therapeutic effects. This is due to the emergence of new physical processes in the body, as well as due to the summation of the effects of changes in physicochemical processes and biological reactions under the influence of a magnetic field. Exposure to a magnetic field causes a general adaptive restructuring of the body, increasing its reserve capabilities.

However, the need to irradiate the sternum for 10-15 minutes and the lesion (wound) from 20 to 40 minutes 2-3 times a day for 6-8 days makes this known procedure quite long and not convenient for both the doctor and the patient . In addition, this procedure is not always comfortable due to the fact that, depending on the location of the skin wound, the patient has to be in one or another, not always comfortable position, for 20 to 40 minutes, and even 2-3 times day.

In addition, the known technique is recommended for its use in the treatment of only long-term non-healing wounds or wounds healing by secondary intention. When using the Gesca series apparatus in cosmetology and plastic surgery, in cases with acute purulent diseases - boils, infiltrates, carbuncles, purulent ulcers, skin burns, phlegmons, pustular rashes and trophic ulcers, other methods and modes of radiation are used and there is no irradiation of zones spongy bones, in particular the sternum.

The presence in the known method of irradiation of only the sternum is not equally effective for patients of different ages. This is due to the fact that with age, the bone marrow content in the spongy bones decreases and the irradiation of the sternum in middle and older patients is not enough to effectively stimulate hematopoiesis and nonspecific immunity. Other carriers of bone marrow are not used in the known technique.

In addition, the implementation in the known method of infrared irradiating a skin wound from the first day after surgery may provoke additional tissue edema in the wound area, which is associated with increased excretion of substances enhancing vascular permeability, such as histamine secreted by mast cells, on the first day after surgery.

Thus, the technical result, the solution of which the claimed invention is directed, is to create a method of treating skin wounds that is effective, simple, convenient, safe, having an expanded scope of its application and the duration of which is 1-3 days in time less than in the prototype.

The specified technical result is achieved by the fact that in the method of treating skin wounds with radiation in the infrared wavelength range, including daily irradiation of the projections of the spongy bones containing bone marrow and skin wounds at the site of injury, according to the invention, the irradiation of the projections of spongy bones containing bone marrow is carried out in the sacrum and ilium for 1-2 minutes per zone, the skin wound is irradiated in a scanning mode from a distance of 0.3-0.5 cm from the surface of the body for at least 1 minute, and as ve radiation in the infrared wavelength range using the infrared laser radiation with a wavelength of 980 nm power of 0.5 W, a power density of 500 mW / cm ^2, the irradiation of each zone is carried out once a day for 3-5 days, and for skin wounds undergoing surgery, irradiation of the projections of the spongy bones and skin wounds at the lesion site, respectively, begin on the first and second days after surgery, and for skin wounds not undergoing surgery, irradiation of the projections gu the bones and the skin wound at the site of injury begin, respectively, from the first and second day after the onset of skin wounds.

The applicant experimentally established that it was the irradiation of the projections of the spongy bones containing bone marrow in the sacrum, iliac bones for 1-2 minutes per zone, irradiation of the skin wound in a scanning mode from a distance of 0.3-0.5 cm from the body surface in for at least 1 minute and, using infrared laser radiation with a wavelength of 980 nm with a power of 0.5 W, a power density of 500 mW / cm ² as radiation in the infrared wavelength range, with irradiation of each zone in the area of the projections of the sponges bones and skin wounds are carried out daily once a day for 3-5 days, and the implementation of irradiation in the area of projections of the spongy bones and irradiation of the skin wound begins from the first and second days, respectively, after surgery or after the occurrence of a skin wound, allows you to achieve the specified applicant technical result.

So, daily, once a day, for 3-5 days, irradiation of the projections of the spongy bones containing bone marrow in the sacrum, iliac bones for 1-2 minutes per zone, using infrared laser radiation with a wavelength of 980 nm with a power of 0, 5 W, with a power density of 500 mW / cm ² , can significantly increase the efficiency of stimulation of hematopoiesis and non-specific immunity. This is achieved by accelerating the regeneration processes, due to the increase in the concentration of autologous stem cells of the patient, which are natural regulators of the recovery processes occurring due to the influence of laser radiation in the infrared and red wavelength ranges of the claimed modes on the claimed hematopoietic organs, stimulating the release of circulating stem cells from the bone marrow in the peripheral bloodstream, where their content increases by 6-10 times.

The acceleration of regeneration processes by increasing the concentration of stem cells is explained by the fact that one of the important sources of stem cells is human peripheral blood, in which a small number of stem cells with CD34 + markers that can differentiate to endothelial and red blood cells, as well as with mesenchymal markers, constantly circulate stem cells differentiating to fibroblasts, nerve cells, etc. To date, more than 30 cytokines and growth factors have been identified in circulating stem cells (CSCs) that paracrine affect the repair of damaged tissues and wound healing that inhibit apoptosis, which are chemoattractants for other CD34 + cells that stimulate vascular growth and microcirculation.

Local application of laser exposure improves microcirculation and repair in areas of tissue defects.

It is a combination of local laser exposure and stimulation of stem cell exit from the bone marrow that allows to increase the concentration of stem cells in the blood, to strengthen the processes of stem cell homing in the area of tissue damage and more rapid repair of tissue defect.

The inventive method allows to reduce the treatment time by 1-3 days. The method is convenient in operation for both the doctor and the patient, since the time of exposure to laser radiation is much shorter than in the closest analogue. In addition, the inventive method does not require repeated use within 1 day.

Used laser exposure modes are selected taking into account the ultradian and circadian rhythms of a person, which further increases the effectiveness of the proposed method of treatment.

Eliminating the effect of laser radiation on the skin wound from the first day after surgery significantly reduces the risk of adverse reactions in the form of edema surrounding the tissue wound.

The inventive method allows it to be used both in the treatment of skin wounds undergoing surgery and for skin wounds not undergoing surgery, which significantly expands the scope of its application.

Testing of the inventive method was carried out on experimental animals. In an animal experiment, an acceleration in the healing of a skin wound was observed when applying the proposed method for 2-3 days. The study was conducted on rats with a surgical wound of the skin of the anterior abdominal wall (3 cm), sutured with nodal sutures and a skin wound, sutured with a cosmetic suture using atraumatic thread. From the first day after the operation, 5 sessions of laser exposure with a power of 0.5 W were performed on the localization zones of the red bone marrow (tail, ilium) and wound skin on the abdomen. A 980 nm laser was used. In the dynamic control group, all manipulations with animals, with the exception of radiation, were reproduced. Biopsy material was taken on 1, 3, 5, 10 days of the experiment. In preparations obtained from animals with laser exposure, on the 3rd day of the experiment, a significant decrease in neutrophilic infiltration was noted compared with the control, edema was less pronounced. On the 5th day, against the background of mast cell activation, pronounced neoagiogenesis and a significantly larger area occupied by fibroblast strands were observed. By 10 days, the density of connective tissue fibers increased and the width of the scar zone decreased compared with the control group, which indicated the beginning of its maturation processes.

An example study on an experimental animal.

A rat weighing 220 g, subcutaneous fat is poorly developed. A surgical wound was modeled in a rat under anesthesia with zoletil. On the front surface of the abdomen, to the left along the white line, 3 cm long skin was cut with scissors, separated from the underlying muscles 0.5 cm from the incision, then the wound was sutured with a cosmetic suture using an atraumatic thread. Irradiation with an infrared laser with a wavelength of 980 nm and a power of 0.5 W was carried out in the position of the animal on the abdomen in the sacral region, iliac bones for 1 minute per zone. The skin wound was irradiated in the supine position in a scanning mode from a distance of 0.5 cm from the surface of the body with an infrared laser of 980 nm with a power of 0.5 W. Irradiation was carried out daily, 5 times. On the 5th day, the wound area was visually assessed - a flat linear scar was identified, pink in color, with soft, well-matched edges, without any detachable and blood crusts. During histological examination of the skin scar preparation, maturing connective tissue was determined, with a well-developed collagen scaffold and proliferating fibroblasts; the blood vessels had differentiated walls.

Example 1. Patient M., 65 years old. A defect in the skin of the back of the shoulder 5 cm long, sutured with a cosmetic seam. 2 days after removal of the lipoma. On visual examination, severe swelling of the skin, the edges of the suture are raised, hyperemic, there is a pronounced exudation, hematoma 2 cm ² in size and multiple petechiae near the wound, severe soreness of the wound. Laser therapy started. Irradiation with an infrared laser with a wavelength of 980 nm and a power of 0.5 W was carried out in a position on the abdomen in the sacrum, ilium for 2 minutes per zone. Irradiation was performed daily. The skin wound was irradiated from 2 days after the operation in scanning mode from a distance of 0.3 cm from the body surface with a 980 nm infrared laser with a power of 0.5 W for 2 minutes. Irradiation was performed daily. In the process of laser therapy, after 1 session (3 days after the operation), edema and exudation are not observed, petechiae disappeared, the hematoma significantly decreased in size, the edges of the wound are well matched, pain does not bother. After 3 sessions of laser therapy (5 days after the operation), the seam is flat, pink, painless, exudation and blood crusts are not noted. The seams are removed. The patient was discharged for outpatient treatment.

Example 2. Patient U, 52 years old. Thermal burn (II degree) of the skin of the anterior surface of the forearm 8 cm long and 5 cm wide, 1 day. On visual examination, severe hyperemia of the skin, multiple blisters with a clear liquid, severe soreness. Laser therapy started. Irradiation with an infrared laser with a wavelength of 980 nm with a power of 0.5 W was carried out in a position on the abdomen in the sacrum, iliac bones for 1 minute per zone. Irradiation was carried out daily for 5 days. The skin wound was irradiated from 2 days in scanning mode from a distance of 0.5 cm from the body surface with a 980 nm infrared laser with a power of 0.5 W for 2 minutes. Irradiation was carried out daily for 4 days. In the course of laser therapy, after 2 sessions, the bubbles subsided, hyperemia of the tissues surrounding the burn was not observed, and soreness was moderate. After 5 sessions of laser therapy, pain does not bother, the burn surface is covered with a scab, exudation is not observed. Wound healing on the 10th day, scab crusts are easily exfoliated, pink skin is visible under them.

Claims (1)

A method of treating skin wounds with radiation in the infrared wavelength range, including daily irradiation of the projections of the spongy bones containing bone marrow, and a skin wound at the site of injury, characterized in that the irradiation of the projections of spongy bones containing bone marrow is carried out in the sacrum and iliac region bones of 1-2 minutes per zone, the skin wound is irradiated in a scanning mode from a distance of 0.3-0.5 cm from the body surface for at least 1 minute, and as radiation in the infrared wavelength range, induce infrared laser radiation with a wavelength of 980 nm with a power of 0.5 W and a power density of 500 mW / cm ² , with each zone being irradiated once a day for 3-5 days, and for skin wounds undergoing surgery, radiation projections of the spongy bones and skin wounds at the lesion site, respectively, begin on the first and second days after surgery, and for skin wounds that are not subjected to surgery, irradiation of the projections of the spongy bones and skin wounds at the lesion site ootvetstvenno from the first and from the second day after the appearance of the skin wound.