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- Easier with steam: battle wounds will be treated with laser and hot bubbles
Easier with steam: battle wounds will be treated with laser and hot bubbles
Russian scientists have developed a method of treating acute and chronic wounds, as well as unwanted formations in tissues and organs. The technology is based on the effect of laser cavitation - the formation and collapse of vapor bubbles caused by heating of liquid under the influence of laser radiation. In this case, the necessary working disposable instrument is collected immediately before the procedure. The new method has shown effectiveness also in the treatment of complex injuries, such as mine blast wounds received during SWO.
How tissues are affected by laser
Scientists from the Institute of Applied Mathematics of the Far Eastern Branch of the Russian Academy of Sciences and the South Ural State Medical University have proposed a new method of treating wounds and eliminating unwanted formations in biological tissues. The specialists are currently obtaining a patent for the proposed method.
Laser device
The development is based on the application of the laser cavitation effect. This is the process of formation and collapse of vapor bubbles, which is caused by heating of liquid under the action of laser radiation.
- The complex, which helps to realize the proposed approach in practice, includes a simple set of equipment and components. It can be assembled immediately before the procedure. The set includes a medical laser device and a quartz-polyamide optical fiber with a diameter of 0.4-0.6 mm. If the fiber is immersed in water and fed with short-wave infrared radiation, which is intensively absorbed by water, it instantly boils at the end of the fiber, which has an area of less than half a millimeter and where the energy density is very high," Mikhail Guzev, academician of the Russian Academy of Sciences and director of the Institute of Applied Mathematics of the Far East Branch of the Russian Academy of Sciences, told Izvestia.
Cavitation on the laser heating element
He added that the vapor-gas bubbles formed during heating quickly collapse due to contact with the "cold" environment, which leads to the generation of hot jets and the formation of shock waves. These processes affect pathological formations, destroying them.
According to the academician, when treating wounds, the working disposable instrument is assembled just before the procedure and consists of a double tube with a small common chamber at the end. On the outer tube with the help of an infusion system (like a dropper) is fed with an aqueous solution of antiseptic, in the inner tube there is an optical fiber. The liquid column in the inner tube with a height of about 10 mm is maintained by pressing the end of the outer tube to the wound surface and regulating the rate of solution delivery. The end of the optical fiber, where laser cavitation occurs, is located 5-6 mm from the wound surface, which is only slightly heated.
Comparison of experimental observations and model calculations
Currently, specialists are working on two directions for practical application of the proposed method. The first of them involves the elimination of pathological structures such as cysts, malformations (blood vessel beds), varicose veins and others.
- For example, when treating a cyst (a pathological cavity in tissues filled with fluid), specialists essentially immerse an optical fiber into it. Due to cavitation, very thin hot jets appear at the tip of the fiber. They carefully treat and destroy the internal lining of cavity pathological formations due to heating, after which they disintegrate and the patient gets relief, - explained Mikhail Guzev.
How to apply the method during combat operations
Another direction is irrigation of infected acute and chronic wounds, said the scientist. In this case, thanks to laser cavitation, there is a directed irrigation of the wound surface with liquid to remove inflammation products and suppress microbial activity, stimulate defense mechanisms in the wound itself, its reparative regeneration. This method has been tested in SWO conditions and has shown good results.
As explained by the scientist, the direct bactericidal effect of the proposed technology has not been found and the effect of accelerating wound sanation is apparently more complex. It is probably related to the destruction of bacterial films. Outside the bacterial films, pathogenic microorganisms become more sensitive to antibacterial drugs, the specialist said.
Complete laser cavitator working part and accessories
At the same time, he noted that the proposed technology does not replace surgical methods of wound treatment, such as opening, drainage and removal of tissues that have lost viability. The tasks of the proposed approach - in the transfer of the wound from the phase of inflammation to the phase of regeneration and preparation for closure - suturing or skin plasty.
- The advantage of laser cavitation is in accuracy and the ability to remove impurities without harming biological tissues. The method allows you to penetrate into small cavities and irregularities. The proposed method can be used to decontaminate hard-to-reach tissue areas," explained Ivan Abushkin, co-developer of the method, Professor of the Department of General and Pediatric Surgery at the South Ural State Medical University.
According to him, one of the areas where laser cavitation has shown its effectiveness is dentistry. With its help, for example, dentists can clean root canals of teeth. Another area is the treatment of mine blast wounds, in which extensive and deep destruction of organs and tissues occurs. In general, experiments have shown the advantages of laser cavitation over ultrasound cavitation. Therefore, the range of its applications in the future is diverse.
Among other things, the technology can be used to remove acne on the face of teenagers or ulcerations. In addition to medicine, laser cavitation may be in demand for cleaning hard-to-reach areas in technical systems and mechanisms, including miniature ones.
Development of the laser cavitation method
In the future, scientists plan to improve the equipment for laser cavitation, equipping it with control sensors. The principle of their operation is based on the fact that the formation and collapse of bubbles creates noise. This effect can be used, for example, to timely limit the temperature rise in the working area of the device above the permissible level, said Mikhail Guzev.
It is also planned to develop a computing complex that will help in determining the optimal parameters of exposure to the method of laser cavitation for each specific patient.
- In clinical work we have not encountered laser-induced cavitation, but we are waiting for portable devices with intuitive control. We would also like laser cavitation to be painless, did not heat tissues and liquids (not boiled and did not cause burns), - said "Izvestia" honored doctor of the Russian Federation, head of the center of wounds and wound infections NMMC surgery named after A.V. Vishnevsky. A.V. Vishnevsky Valery Mitish.
He noted that the known effect of ultrasonic cavitation helps to clean the wound surface from tissue detritus, wet necrosis, contributes to the destruction of microbial biofilms and prevents their formation, improves microcirculation of the wound bed and surrounding tissues. According to the medic, the proposed technology will have a similar effect. And with laser cavitation will also be possible countercurrent, anti-inflammatory and analgesic (anesthetic) activity.
In the future, emphasized Valery Mitish, for the development of the technology need comparative studies of the use of laser radiation of different wavelengths and different solutions (not only saline sodium chloride, but also solutions of antiseptics, antibiotics).
- There are many products on the market for thermocoagulation (thermal treatment of biotissues). However, the Russian development is not inferior to foreign samples. The effectiveness of the new technology for destruction of biofilms and removal of non-viable tissues is obvious and in demand. Nevertheless, as presented, the device creates a point impact, which prolongs the procedure of wound sanation, - commented Ivan Vinokurov, surgeon, chief researcher of the NCC № 3 of the Petrovsky Russian National Cancer Center named after academician B.V. Petrovsky.
In general, in his opinion, the technology is understandable to the medical community. To implement it, we need a production base and a competitive price.
- The method of ultrasonic cavitation is widely used. But now in medical centers the majority of devices are mainly from China. The presented development will contribute to advanced import substitution - when domestic devices are an order of magnitude better than imported ones," said Olga Tarasova, Director of the ANO Center for Development of Scientific and Educational Initiatives and co-author of the Nasha Laba project.
Moreover, she added, the equipment will be in demand not only in medicine, but also in science in general. While the development has not yet received a registration certificate for a medical device, it can be used to solve biotechnological problems.
Переведено сервисом «Яндекс Переводчик»
