Application of photodynamic therapy in complex treatment of purulent diseases of the hand

Abstract

For many years, the treatment of purulent diseases of the hand has stayed relevant. Despite the progress in modern medicine, this pathology retains its prevalence and, most importantly, is often found in patients of the working age, which determines the socio-economic importance of the search for new approaches to the treatment of purulent diseases of this localization. In the purulent surgery department of State Clinical hospital № 4, a study and treatment of two groups of patients were carried out: patients with phlegmons and felons of the hand with open management of postoperative wounds using traditional treatment methods (antibiotic therapy, immobilization, dressings with antiseptic solutions and ointments, the use of wound enzymes) and with the use of photodynamic therapy (PDT) in the postoperative period. PDT was performed on the second or third day after opening the phlegmon or felon using an ATKUS-2 semiconductor laser (AO “Poluprovodnikovye pribory”, Russia) with an output power of 1 to 2 W, an operating wavelength of 660 ± 0.03 nm and an energy density between 20 and 25 J/cm² after application of the photosensitizer based on chlorin e6 to the treated wound area. The article describes the technique of PDT in patients with purulent diseases of the hand. It was found that it is optimal to perform PDT as early as possible after the operation period, but not earlier than on the second day after the operation, because earlier dressing is especially painful in the absence of sutures and can lead to bleeding from a postoperative wound when the dressing is removed. The effectiveness of treatment in the studied groups was evaluated: the terms of inpatient healing in the groups were compared; the dynamics of the course of the wound process was analyzed. When comparing the results of the two groups, a significant acceleration in the healing of the postoperative wounds was noted in patients for whom PDT was used – 5 days (1.4 times) faster compared to treatment according to the generally accepted technique. The early appearance of granulations and the antibacterial effect of this procedure are noted, which significantly improves the treatment outcome for this pathology. This makes the use of PDT relevant and appropriate in the complex treatment of purulent diseases of the hand

Keywords

• photodynamic therapy
• purulent diseases of the hand
• drainage system
• photosensitizer
• necroectomy