RU2726599C1 - Method of treating wounds - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery, particularly to combustiology, and can be used for treating wounds and burns. On the first day after the injury, the wound is surgically treated, in the course of which the wound surface is once exposed to the low-temperature air plasma flow of atmospheric pressure of the positive corona discharge on the background of exposure of the variable frequency-modulated electric field signal with subsequent application of hydrogel based on CARBOPOL ETD 2020 with silver-containing antiseptics dissolved therein.

EFFECT: method enables accelerating wound and burn healing ensured by synergetic effect of using three different wound healing methods when suppressing pathogenic microflora, creating the required degree of moistening, preventing formation of secondary necrosis zones, improving microcirculation processes and accelerating reparative regeneration.

1 cl, 1 tbl, 1 ex

Description

The invention relates to the field of medicine and surgery, in particular, combustiology, and can be used to treat wounds, burns, various defects of the skin.

The known method of treatment, providing for the impact on biological tissue flow of plasma (US Pat. RF No. 2183480 C2), in which the biological tissue is affected by a flow of electrically neutral thermally equilibrium air plasma. The formed beam of air plasma is directed to the area of localization of the biological tissue to be treated, and then they are brought into direct contact.

The above-described method of treating wounds is characterized by low efficiency, duration and complexity of implementation, the need for a course of repeated exposure to the wound surface, as well as the impossibility of quick treatment of extensive wound surfaces.

A known method of treating a burn wound by using the energy of magnetic and electromagnetic fields (Musienko K.S. et al. Study of the effect of physical fields on the physicochemical properties of water // Biomedical engineering and electronics. - 2014. - No. 2. - P. 84- 90).

A known method of local treatment of wounds by exposure to an alternating frequency-modulated electric field signal, incl. participating in the generation of low-temperature corona discharge plasma (Ivanov AV Study of the Raman spectra of water under the influence of variable frequency-modulated potential / Izvestiya SPb UGPS EMERCOM of the Russian Federation. - 2014. - No. 4. - P. 45-50; Ross CL [ et al] The effect of low-frequency electromagnetic field on human bone marrow stem / progenitor cell differentiation // Stem Cell Research. - 2015. - Vol. 15, No. 1. - P. 98-108).

A known method of treating soft tissue injuries (US Pat. RU, No. 2160130), in which the damaged tissue is exposed to an electromagnetic field directed directly to the vascular network of the damaged tissue and inducing a current at a pulse repetition rate.

A known method of treating long-term non-healing wounds (US Pat. RU No. 1754125) by electrostimulation with direct current with a force of up to 200 μA with a duration of parcels and pauses of 80-100 μs, daily for 40-45 minutes.

The known method of electrophysical effects on metabolic processes in humans and animals (US Pat. RF RU 2016138930 A), in which an alternating frequency-modulated low-frequency electric field is used as an electrophysical effect.

The disadvantages of these methods are the complexity of their implementation in practical medicine, the excessive duration of the proposed course of therapy, as well as low efficiency, extremely weak bactericidal effect, the possibility of direct damage to living tissues, the formation of zones of secondary necrosis.

Closest to the claimed is a method of treating trophic tissue defects with an electric field (US Pat. RU 2261732). During its implementation, the surface of damaged tissues is exposed to an electric field received from a corona electrode located inside the body.

The disadvantages of the method chosen as a prototype include the absence of a primary antimicrobial effect in an alternating electric field, as well as the impossibility of suppressing the development of wound infection only with its help, as a result, an insufficient rate of regeneration of the affected tissues and low treatment efficiency during its implementation.

The objective of the claimed invention is to accelerate the healing of wounds and burns by suppressing pathogenic microflora, creating the necessary degree of moisture, preventing the formation of secondary necrosis zones, improving microcirculation processes and accelerating reparative regeneration.

The technical result of the task is achieved by the fact that in the method of treating wounds and burns, based on the effect on the wound surface of a flow of low-temperature air plasma, a frequency-modulated signal of an electric field and an antiseptic hydrogel, in the first 24 hours after the injury at the stage of surgical treatment of the wound, a single exposure is performed on the wound surface of a flow of low-temperature air plasma of atmospheric pressure of a positive corona discharge at a distance of 0.5-1 cm from the wound with a duration of exposure to the plasma flow on an area of 10 sq. cm up to 30 seconds against the background of an exposure of 15 minutes of an alternating frequency-modulated electric field signal from a single electrode located along the perimeter of the wound, followed by application of 1% hydrogel based on CARBOPOL ETD 2020 to the wound.

Performing wound treatment on the first day after injury minimizes the risk of developing a wound infection. In the same period, the treatment of the wound surface with NVPADKR at a distance of 0.5-1 cm with a 30-second duration of exposure to the plasma flow on an area of 10 sq. cm provides complete elimination of residual microflora on the wound surface. The simultaneous exposure to an alternating frequency-modulated electric field signal for 15 minutes ensures a reliable potentiation of the antimicrobial effect of CARBOPOL ETD 2020 with dissolved silver-containing antiseptics.

The method is carried out as follows. In the first 24 hours after the injury, the wound is surgically cleaned, during which the wound is revised, washed with non-cytotoxic antiseptics (aqueous solutions - miramistin, prontosan, povidone-iodine), non-viable (dead) tissues, scabs are mechanically removed, after which a single effect on the wound surface of a flow of low-temperature air plasma of atmospheric pressure of a positive corona discharge (NVPADPKR) at a distance of 0.5-1 cm from the wound with a duration of exposure to the plasma flow on an area of 10 sq. see up to 30 seconds against the background of an exposure of 15 minutes of an alternating frequency-modulated signal (FMS) of an electric field from a single electrode covered with gauze and moistened with distilled water, located along the perimeter of the wound, followed by application to the wound of 1% hydrogel based on CARBOPOL ETD 2020 with silver-containing antiseptics dissolved in it (poviargol or silver sulfadiazine).

The effectiveness of the combined use of NVPADPKR and CHMS of the electric field followed by the application of a hydrogel based on CARBOPOL ETD 2020 with antiseptics for full-thickness skin wounds was performed in a series of experiments with the participation of rodents. In the course of the experiment, a planimetric assessment of the duration of the phases of the wound process, the features of the course of typical pathological processes - the formation of zones of necrosis, an inflammatory reaction, changes and features of microcirculation, an increase in regenerative processes (periods of cleansing from necrotic tissues, scab, wound detritus, as well as the appearance of foci of marginal / focal epithelium of wounds and the timing of its completion), as well as the features of the antimicrobial effect of NVPADPKR and the possibility of enhancing the ability to suppress pathogenic microflora with antiseptics dissolved in a hydrogel against the background of the impact of an electric field HMS.

Comparative results of assessing the duration of the periods of cleansing wounds from non-viable tissues and the timing of their healing due to contraction and epithelialization in the studied groups of individuals, assessed planimetrically, are shown in Table 1, the data of which indicate that the treatment of the wound surface with NVPADPCR against the background of the impact of an electric field HMS optimizes the course of typical pathological processes, significantly increases the effectiveness of the wound healing agents tested by us on the model of a full-thickness skin wound, while there is a positive trend compared with the isolated use of only NVPADPKR for this purpose.

In particular, in the group of animals, where the treatment of wounds was treated with NVPADPCR in conjunction with the HMS of the electric field, the terms of wound cleansing and their final healing were reduced, respectively, by 19-20% (p <0.05) compared with the isolated application of the plasma flow ...

The combined use of NVPADPKR against the background of an electric field PM and 1% hydrogel based on CARBOPOL ETD 2020 with a silver-containing antiseptic dermazine (silver sulfadiazine) reduced the time for scab rejection and wound healing, compared with the use of a hydrogel or hydrogel against the background of an electric field PM, respectively, by 27 -40% (p <0.01) and 18-24% (p <0.05).

When using a plasma flow, an alternating electric field and 1% hydrogel based on CARBOPOL ETD 2020 with a silver-containing antiseptic poviargol, the analyzed parameters decreased, respectively, by 29-41% (p <0.01) and 24-31% (p <0.01 ). These data clearly indicate the presence of a synergistic effect when using three different methods of wound healing, when the additive effect (general pharmacological effect) of all methods that do not have the same mechanism of action is more pronounced than with the isolated action of these therapeutic factors.

Example. Injured P-in. D., 44 years old, 03/12/2016, hospitalized in the burn department of the State Healthcare Institution Leningrad Regional Clinical Hospital (Toksovo, Vsevolozhsky District of the Leningrad Region, Bulanova St., 18-20) due to a bite wound of the right forearm with an area of up to 50 sq. ... see, 12 hours after the injury The wound is represented by a full-thickness defect, its bottom is the flexor tendons of the forearm. Upon admission, the wound was surgically cleaned, the wound was revised and washed with non-cytotoxic antiseptics (miramistin, prontosan, povidone-iodine), mechanically removed non-viable (necrotic) skin edges up to 5 sq. see Performed a single exposure to the wound surface by the claimed method. In the postoperative period, the wound is without signs of inflammation, active healing due to granulation, contraction, cicatricial contraction against the background of daily dressings. Discharged from the hospital on the 8th day after the injury in a satisfactory condition under the supervision of the surgeon of the polyclinic at the place of residence.

Claims (1)

A method of treating wounds and burns, based on the effect on the wound surface of a flow of low-temperature air plasma, a frequency-modulated signal of an electric field and antiseptic hydrogels, characterized in that in the first 24 hours after injury, at the stage of surgical treatment of the wound, a single effect on the wound surface of the flow of low-temperature air plasma of atmospheric pressure of a positive corona discharge at a distance of 0.5-1 cm from the wound with a duration of exposure to the plasma flow on an area of 10 sq. cm up to 30 seconds against the background of an exposure of 15 minutes of an alternating frequency-modulated electric field signal from a single electrode located along the perimeter of the wound, followed by application of 1% hydrogel based on CARBOPOL ETD 2020 with silver-containing antiseptics on the wound.