Global Journal of Medical Research, F: Diseases, Volume 22 Issue 1

7 Year 2022 Global Journal of Medical Research Volume XXII Issue I Version I ( D ) F © 2022 Global Journals Optimization of Treatment Methods for Purulent-Destructive Soft Tissue Diseases through the use of Laser Treatment Methods the pathogen in the seeding on the 10th day of the study. In contrast, in group I of patients who received traditional treatment in combination with PDT, no growth of microbes was found. On the seventh day of examination in 12% of patients, and in the last study - in 59% of patients, which is 1.8 times more than in the control group. The best results were achieved in group II of the surveyed who received complex therapy - traditional treatment + PDT + CO2 laser: elimination of the pathogen was observed on the seventh day in 36% of patients, which is 3 times higher than the indicators of group I patients. On the tenth day, the absence of growth was already in 67% of patients in this group, which is also higher than those of group I by 1.1 times, and in the control group of patients by 2 times. The data obtained allow us to conclude that the proposed method of treatment is highly effective. Morphological studies have shown that, before surgical treatment, during histological studies, the walls and bottom of the wound are represented by destructive necrotic tissues, abundantly infiltrated by polymorphonuclear leukocytes, the tissues are edematous having venous and capillary plethora, stasis, perivascular diapedetic and focal hemorrhages. The study of the dynamics of acute purulent- inflammatory diseases of soft tissues after traditional treatment showed that on the 3rd day, purulent- destructive and necrobiotic changes with infiltration of neutrophilic leukocytes prevailed in almost all types of purulent diseases. By the 7th day of traditional treatment, infiltration of neutrophilic leukocytes is more often observed, the number of abscesses and foci of necrosis increases, and the destruction of specific tissue structures is observed. By the 10th day of the examination, the processes of edema and destruction in the purulent-inflamed tissue calmed down somewhat, certain boundaries appeared in the areas of neutrophilic infiltration, proliferative inflammation developed around the foci of abscesses and necrobiosis, and connective tissue was formed. IV. D iscussion Thus, the presented data convincingly prove the high clinical efficacy of antibacterial therapy based on a CO 2 laser and photodynamic effects caused by the simultaneous action of a physical and chemical factor on the pathogenic microflora. According to the literature data, the effectiveness of methylene blue as a photosensitizer in PDT has also been proven. Methylene blue has no dark toxicity to living cells. The photosensitizer and white light alone do not have photodynamic antimicrobial activity. Methylene blue had the maximum antibacterial activity at a concentration of 50 uM (0.05%). Considering the above positive qualities, methylene blue makes it possible to widely recommend photodynamic therapy of purulent wounds in clinical medicine. At the beginning of the twentieth century, the idea of a "magic bullet" was expressed by Paul Ehrlich, who suggested that incubation of bacteria with methylene blue dye should cause them to die when exposed to light. The effect of other photosensitizers was expressed to one degree or another, but the maximum effect with the minimum dose of laser radiation was achieved with the use of methylthioninium chloride (methylene blue) and zinc phthalocyanine [41]. The European Laser Association in 1997 published the work of S.E. Milson et al. [41,42], which reported that H. pylori after incubation with methylene blue, toluidine blue and hematoporphyrin derivatives was successfully inactivated at doses of 50 and 100 J / cm2. The best photoinactivation effect was observed at a dose of 50 J / cm2 with methylene blue. The work noted that the dose of 50 J / cm2 is far beyond the damaging effect of laser radiation on the gastric mucosa [42]. The combined effect of PDT with methylene blue and a weak electric current (l mA) on E. coli in vitro in order to enhance the effect of PDT increases the efficiency of PDT [34]. The effect of preliminary laser irradiation of bacteria before incubation with a photosensitizer is interesting. In cases where APDT was applied to highly resistant bacteria such as the microbacterium tuberculosis, preliminary laser irradiation disrupted the structure of the cell wall in vitro and made the bacterium more susceptible to APDT [7]. PDT with methylene blue and irradiation with broadband white light (400-700 nm) at a dose of 10 J / cm2 inactivates Qb-bacteriophage RNA in vitro by linking it with plasma proteins [44]. The obtained clinical, histological, microbiological and immunological data indicate that photodynamic therapy with a laser and non-laser light source is a fairly effective non-invasive method for treating purulent wounds and serve as a rationale for the application of the method of photodynamic therapy in clinical practice for the treatment of local acute suppurative inflammation, in particular for the treatment of purulent proctological pathology [11]. The use of local photodynamic therapy in complex treatment with the use of laser radiation using the ALT "VOSTOK-03" apparatus and a photosensitizer of 0.05% methylene blue solution allows in a short time to achieve cleansing of wound surfaces from pathogenic microflora, to ensure the normalization of signs of intoxication in a shorter time compared to traditional treatment, to achieve a decrease in the number of progression of the pathological process on the foot from 31.5% to 6.7%, as well as a decrease in the number of deaths from 10.5% to 2.2% [29]. The optimal concentration of methylene blue in vitro, as well as the duration of laser radiation with a