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 – 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.

 
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