Open AccessPhotodynamic therapy of gunshot wounds soft tissue
Author(s) -
R.N. Mikhaylusov,
V. V. Nehoduiko,
A. N. Veligotsky,
Sergey Romaev,
L.Yu. Svirydenko
Publication year - 2019
Publication title -
fotobìologìâ ta fotomedicina
Language(s) - English
Resource type - Journals
eISSN - 2523-4617
pISSN - 2076-0612
DOI - 10.26565/2076-0612-2019-28-04
Subject(s) - photodynamic therapy , medicine , antibiotics , soft tissue , surgery , wound healing , photosensitizer , infiltration (hvac) , microbiology and biotechnology , chemistry , materials science , organic chemistry , biology , composite material
. An important component of the treatment of gunshot wounds is antibiotic therapy.Unfortunately, due to the antibiotic resistance of many strains of microorganisms, there remains a risk of purulent-infectious complications even with prolonged antibiotic therapy. In recent years, methods of physicalaction, in particular, photodynamic therapy (PDT), have been used to accelerate bacterial decontamination ofwounds. Gunshot wounds have their own characteristics that create certain difficulties for the application ofthe method of photodynamic therapy.Purpose. Аnalyzes the results of the application of the developed PDT method in the complex treatmentof gunshot wounds of soft tissues.Materials and methods. A comparison was made of the main indicators of the wound healing processbetween the wounded of the main group who used PDT (n = 52) and the comparison group (n = 32) who usedtreatment with complex water-soluble ointments. To increase the effectiveness of the method, the «Photolon»photosensitizer was administered in two ways: by injection infiltration of tissues around the wound and by applicationdirectly to the wound surface. The wavelength of laser radiation is 660 nm. The dose of laser energywas 20 J/cm2.Results. The results of the study showed an improvement in the course of the wound process in all respectswhen using PDT: the period of regression of local edema in the main group on (3.7 ± 0.4) days in the comparisongroup (6.2 ± 0.5), the period of wound cleansing (4.7 ± 0.6) days (7.3 ± 0.8) days, respectively; the timing of thestart of granulation (4.6 ± 0.5) days and (7.8 ± 0.6). At the beginning of treatment, 45 pathogenic strains wereisolated in 38 (73.1 %) wounded main groups and 26 strains in 22 (68.7 %) wounded comparison groups. A dayafter the use of PDT, pathogenic wound microflora was isolated in 5 (9.6 %) wounded main groups — 5 strainsand 23 strains in 19 (59.4 %) wounded comparison groups.Conclusions. The effects of PDT were observed: rapid inactivation of pathogenic wound microflora,reduction of edema, pain syndrome and stimulation of granulation growth, which contributes to early closureof wounds.