COMPLEX APPLICATION OF LASER RADIATION
IN TREATMENT OF CHILDREN FOR SUPPURATIVE INFLAMMATION DISEASES
Chekmaryov VM, Alexandrov MT,
Krivikhin VT, Akhmedov MA
Moscow Regional Center Laser Surgery
The specific anatomic and physiological features of the children��s
organism bring about the severity of duration and high lethality in the
evolution of suppurative infection.
There are a number of positive physiological and therapeutic
effects proving the pertinence of development of laser radiation methods application
for treatment of suppurative inflammation diseases (SID) in the children��s
age. Earlier carried out experimental investigations and clinical study
ascertained the absence of side effects at laser applications in adequate
doses in the children��s age. At the same time, there are few studies on the
complex use of high- and low-energy laser radiation (LELR) for the pussy
surgical pathology treatment of children.
The high- and low-energy laser radiation (LR) was used in the
treatment of 622 children with local and generalized pussy infection. The
reference group consisted of 51 children practically in good health. The
following laser medical instruments were used: CO2 - laser scalpel, double-beam laser
biophotometer (LBP) (l=0.63 mcm, l=0.89 mcm), laser doppler flowmeter (LDF) (l=0.63 mcm), medical instruments with laser
radiation (l=0.63 mcm and l=0.89 mcm) and a set of laser lightguides, heads
for external, intracavernous and endovascular blood radiation. For
assessment of treatment results, clinical, laboratory and immunological
investigations were carried out, studying the cyrology of the wound
separation with the wound planimetry and biophotometry (LBP).
The analysis of the treatment results of 622 children with SID
enables to make the following conclusions:
1.
Double-beam LBP and
LDF present an objective method of an early diagnostics of suppurative
complications in the wound. Differential diagnostics of serous and
suppurative inflammation, allow to control the duration of the local
inflammation process. Objectively batch LELR of red and infrared spectrum
in various phases of the suppurative inflammation process, objectively
evaluate the viability and define the borders of intestinal walls resection
by the change of optical characteristics of tissues.
2.
The use of LELR for
treatment SID is efficient only with the provision of individual dosing.
The optimal results of treatment SID were obtained with the combined use of
LELR with ultrasonic cavitation and regional lymphotropic antibiotic
therapy. The low-energy skin spot laser effect on blood in the projection
of the main vessels location is the method of choice, in comparison with
the endovascular method, especially with the children of early age.
3.
Treatment of a pussy
cavity with CO2 �C laser in combination with ultrasonic
cavitation and the following vacuum aspiration, stitching of the wound,
lymphothropic antibiotic therapy allows to get the healing of the primary
type. The use of laser scalpel is the method of choice for opening necrotic
phlegmons of newborns, pseudoboils, omphalitides, ingrown nails , phimosis
complicated by balanopostitis, abscesses, phlegmons, especially with
children having blood coagulability disorders.
Thus, the effective application of laser radiation in the children��s
surgery is practicable due to the possibility of early diagnosing of pussy
complications�� evolution. Individual approach to objective dosing of laser
radiation, on the basis of LBP and LDF data, assessment of immunograms,
taking account of the suppurative process phase, the age, as well as strict
observance of indications and laser scalpel operations technique. On the
basis of the investigation materials, 9 patents and inventor��s certificates
have been received.