In our age of great technology and high speeds, unfortunately, there are often moments when a person receives one or another injury. It is much more difficult if the injured part of the body is the head, and even more so, its facial part.
Since the human face is a very complex part of the body, surgeons have a great responsibility for correcting traumatic defects and deformities in this area.
So what needs to be done if something irreparable happens and someone, despite all attempts to correct the situation, still receives a facial injury. Firstly, do not panic; you need to seek help from a specialist, for example, the Center for Dentistry and Maxillofacial Surgery, as quickly as possible. At our Center, specialists have everything necessary to diagnose and treat various facial injuries, with the exception of serious concomitant and combined injuries, when the help of many specialists is required in an inpatient setting.
Despite the fact that injuries vary in complexity, we still recommend visiting an oral and maxillofacial surgeon to rule out the possibility of a more serious injury, such as an abrasion or hematoma.
So let's figure out what types of facial injuries there are.
Causes of non-healing wounds
The immediate cause of non-healing wounds is insufficient activity of restoration processes in the body, slow tissue regeneration. Moreover, the conditions under which regeneration slows down can be varied.
Among the general factors (i.e., affecting the state of the body as a whole), the following can be identified:
• weakened immunity due to concomitant disease or chronic immunodeficiency state;
• chronic intoxication of the body;
• metabolic disease;
• diabetes; this condition can be considered a severe form of metabolic disorder, namely glucose metabolism. Disturbances in the normal absorption of glucose lead to increased tissue fragility and a slowdown in the regeneration process;
• circulatory disorders - both general and local. The cause may be atherosclerosis, deformation of vascular walls, and diseases of the cardiovascular system. Local circulatory disorders can be caused by prolonged compression of tissues and pinching of small blood vessels (an example of a chronic wound against the background of constant compression of tissues - bedsores);
• hypo- or avitaminosis of vitamins A, C, K and group B, which play an important role in the process of tissue regeneration;
• lack of calcium or zinc in the body;
• exhaustion – nutritional (due to insufficient or malnutrition) or senile;
• presence of cancer.
A specific factor in the appearance of chronic wounds is poor circulation in the legs, most often due to varicose veins. Against the background of impaired blood circulation, trophic ulcers develop on the legs (usually in the shins) - difficult-to-heal tissue defects.
Local factors affecting the wound itself and the area around it include:
• infection;
• the presence of necrotic tissue in the wound (they increase the risk of suppuration and, accordingly, the duration of healing);
• presence of foreign bodies in the wound;
• the presence of bleeding in the wound (also increases the risk of infection);
• repeated damage to an unhealed wound.
The risk of a wound becoming chronic increases if, in addition to the skin, other tissues are damaged - subcutaneous tissue, nerves, muscles, tendons, bones.
Actovegin
"Actovegin" is a wound-healing ointment with complex action. The main task of the drug is the destruction of bacteria and tissue regeneration. You can buy Actovegin in the form of ointments, tablets or injections. The drug contains: deproteinized calf blood hemoderivate, povidone. Actovegin increases the concentration of amino acids in the blood and helps heal even old wounds that have not healed for a long time. Actovegin ointment is inexpensive, it lasts for a long time, among the disadvantages is a list of side effects that you should definitely familiarize yourself with.
Actovegin
Nycomed, Switzerland; Takeda, Japan; Kusum Healthcare Pvt. Ltd., India
Actovegin activates cellular metabolism (metabolism) by increasing the transport and accumulation of glucose and oxygen, enhancing their intracellular utilization.
These processes lead to an acceleration of ATP (adenosine triphosphoric acid) metabolism and an increase in the energy resources of the cell. from 231
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Symptoms of non-healing wounds
•constant pain;
•converging edges of the wound;
•constant bleeding;
• “stuck” wound at one of the stages of healing for more than three weeks;
•often – unpleasant odor;
•conventional treatments do not help or help little.
These signs indicate that the regeneration processes in tissues are disrupted for one reason or another. For the treatment of chronic wounds, local treatment is not enough; comprehensive measures are required.
To achieve progress in healing, it is necessary to provide conditions for restoring the normal rate of regeneration. They largely depend on the cause of the chronic wound, but there are recommendations that are common to all situations.
The body needs to provide:
•balanced nutrition - in particular, the diet should be enriched with vitamins A and B, which stimulate tissue regeneration, and vitamin C, which promotes the production of collagen - a substance involved in the formation of connective tissue that closes the wound in the first stages;
•normal sleep mode – during sleep the regeneration process occurs more actively;
•protecting the wound and the area around it from external influences, such as rubbing, squeezing, etc.;
•wound ventilation – without air circulation, the wound will quickly fester.
More specific recommendations depend on the origin and nature of the wound.
Vulnuzan
This ointment for wound healing contains mother liquor of Lake Pomorie, castor oil, tylose C-30, anhydrous lanolin, distilled water. This drug perfectly treats wounds and burns. “Vulnuzan” consists entirely of plant components, does not provoke allergic reactions, helps with wound suppuration, the ointment is suitable for mucous membranes and is quite affordable. Among the disadvantages is that you can’t buy “Vulnuzan” in every pharmacy; the ointment is not suitable for pregnant and lactating women.
Vulnuzan
Sopharma AD, Bulgaria
Vulnusan ointment is a drug with anti-inflammatory, antimicrobial and tissue regeneration-improving effects.
A preparation of natural origin for external use, obtained by processing the mother liquor of Lake Pomorie. It has anti-inflammatory, antimicrobial and tissue regeneration-improving effects. from 124
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Treatment of non-healing wounds taking into account their cause
When starting to treat injuries of this kind, it is necessary to understand the cause of their occurrence. Further actions will depend on this.
1. First of all, it is necessary to examine the wound for foreign bodies, necrotic tissue, and bleeding and, if necessary, clean it. Please note that it is strongly recommended not to remove foreign bodies yourself! Such attempts may cause additional tissue damage and increase the risk of infection. You need to seek help from a doctor.
2. If local blood circulation is impaired, it is necessary to eliminate the source of pressure on the tissue (change the position of the patient’s body with bedsores, wear looser clothes/shoes for “diabetic” wounds).
3. When treating trophic ulcers on the legs, it is necessary to use compression stockings or bandages - they will help “support” the blood vessels and normalize blood circulation, as well as “pull” the edges of the wound towards each other for faster healing.
4. In case of exhaustion and vitamin deficiencies, it is necessary to provide a normal balanced diet in order to provide the body with the necessary substances for tissue regeneration and the production of collagen - a substance that is actively involved in the early stages of the healing process and helps tighten the edges of the wound.
5.If you have diabetes (of any type), you need to monitor your blood glucose levels.
After creating optimal conditions for wound healing, you can begin to treat and treat it.
What are the types of facial injuries?
They can be divided into four groups:
- Cuts and scratches
- bruises,
- abrasions,
- lacerations.
In addition, facial injuries vary in severity and, accordingly, the principles of medical care differ .
So, a small bruise or minor scratch usually does not require any special measures. Abrasions require contacting a specialist only if they are small, not near the eyes, and if there is no foreign body stuck in them.
In the event of a minor facial injury, thoroughly rinse the wound with water to reduce the risk of infection. Then treat it with an antiseptic and, if necessary, apply a bandage. If you have not had a tetanus vaccination, you should get it.
Principles (stages) of treatment
Actions when treating a wound depend not only on the conditions and causes of its appearance, but also on the stage at which the wound process has stopped in it.
The first stage of the wound process is acute. During it, vascular changes occur caused by a reaction to damage, and the process of blood clotting is actively underway. If the wound is infected, pus is formed and toxic substances are simultaneously absorbed into the tissue.
At this stage, it is necessary, first of all, to clean the wound - remove dead tissue from it, remove foreign bodies (with the help of a doctor), drain it - remove pus and exudate from the wound. It is also necessary to prevent infection from entering the wound. It is best to wash the affected area with saline solution, as caustic disinfectant liquids can harm surrounding healthy tissue.
The second stage of the wound process is granulation. At this stage, a thin layer of connective tissue begins to form on top of the wound. The edges of the wound begin to tighten, and it closes itself. The thinnest capillaries are formed in the connective tissue layer, providing nutrition to regenerating tissues. Often chronic wounds stop at this phase, and the healing process does not proceed further; This is most often what happens with trophic ulcers.
At the granulation stage, it is important, firstly, to protect the newly formed tissue from mechanical damage, secondly, to stimulate further regeneration, and thirdly, to prevent the development of the inflammatory process - despite the fact that the wound is closed, the risk of infection and inflammation remains. To stimulate tissue regeneration, methyluracil ointment is used (you can use a ready-made Voskopran dressing with methyluracil ointment); to protect the surface of the wound, atraumatic dressings should be used that do not stick to the wound surface and do not injure it.
We should not forget about maintaining a maintenance diet and sleep schedule - this will help speed up the healing process.
Eplan
A universal anti-inflammatory agent that is recommended for use immediately after injury. "Eplan" quickly stops bleeding, reduces pain, and relieves swelling. You can buy Eplan both in the form of a liquid solution, and in the form of a cream or special napkins soaked in the drug. The active ingredient of the drug is glycolan. "Eplan" can be used to disinfect a wound and destroy pathogenic microflora before applying other wound healing agents. "Eplan" is prescribed for bedsores, frostbite, burns, cuts, abrasions, herpes, ulcers, weeping eczema.
Eplan
Oberon, Russia
Burns of various types: solar, chemical thermal; Frostbite; various skin injuries, including bruises, cuts, wounds, cracks and abrasions; Radiation damage to the skin; Bedsores and trophic ulcers; Psoriasis; Streptococcal or staphylococcal pyoderma; Dyshidrosis (pompholyx, which can be complicated by a secondary infection) or microbial eczema; Acne vulgaris; Papillomavirus infection, the presence of condylomas, herpes or warts; Otitis, otomycosis; Boils in the nose; Sycosis; Swelling and itching from the bites of insects such as mosquitoes, bees, wasps, etc.; Preventive a skin protection product when working with chemicals and aggressive environments, including detergents, fertilizers, solvents, etc. Eplan cream is also used in veterinary medicine for similar diseases of domestic animals.
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Dressings for the treatment of non-healing wounds
When treating wounds of any nature, including chronic ones, the correct selection of dressing material plays an important role.
Dressing material for non-healing wounds should be:
•hygroscopic;
•"breathable";
•elastic and flexible – the bandage will have to be worn for a long time, so it should not interfere with movements.
Biotekfarm company offers a wide selection of dressings for the management of wounds of any complexity and at any stage. So, for wounds in which there are fragments of necrotic tissue or hemorrhage, a Parapran dressing with chymotrypsin is suitable - the drug included in the dressing helps to break down necrotic tissue, helping to cleanse the wound.
To moisturize “dry” chronic wounds (bedsores, trophic ulcers) and accelerate their healing, it is recommended to use the “GelePran” dressing with miramistin or colloidal silver. This soft transparent dressing, consisting of 70% water, moisturizes the surface of the wound, and the medicine it contains (miramistin or silver) disinfects and promotes regeneration.
For the treatment of infected wounds, bactericidal dressings Voskopran with Povidone-iodine ointment, antimicrobial dressings Voskopran with Dioxidin ointment, and anti-inflammatory dressings Voskopran with Levomekol ointment are suitable. Polipran dressings with Dioxidin are excellent for preventing infection of wounds at the granulation stage.
The Chitopran dressing based on chitosan nanofibers will help stimulate regeneration. It provides optimal conditions for healing - sufficient humidity, breathability and protection from damage, and promotes the rapid growth of its own cells. It is worth paying attention to the fact that this bandage does not need to be removed - it resorbs on its own as the wound heals.
Baneocin
Baneocin ointment works as an antiseptic and has a healing effect. You can buy Baneocin both in the form of an ointment (to help the wound heal better) and in the form of a powder (it can be applied immediately after injury). The drug contains two antibiotics: bacitracin and neomycin. "Baneocin" relieves inflammation of wounds and is also suitable for the treatment of pustular rashes. The ointment helps in the fight against umbilical infection in newborns, and is also indicated for the treatment of diabetics. Contraindications include: cannot be used on mucous membranes, with a large area of damage, during treatment with other antibiotics, or with renal failure. Among the disadvantages are the high price and a list of contraindications.
Baneocin
Sandoz, Germany
Infectious and inflammatory skin diseases caused by microorganisms sensitive to the drug: - bacterial skin infections of limited prevalence, incl.
weeping contagious impetigo, infected trophic ulcers of the lower extremities, infected eczema, bacterial diaper dermatitis, secondary bacterial infection in diseases caused by Herpes simplex, Varicella zoster (including infection of vesicles with chickenpox); —prevention of umbilical infection in newborns; - prevention of infection after surgical (dermatological) procedures: for additional treatment in the postoperative period (after tissue excision, cauterization, episiotomy, treatment of cracks, perineal rupture, weeping wounds and sutures). from 183
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Wound healing time and consequences
Healing a chronic wound is a long and complex process that can take from 1 to 3 months, depending on the depth and size of the wound. It should be borne in mind that epithelization of chronic wounds is very slow - no more than 1 cm per month. After complete epithelialization, the “new” skin increases its strength for another 6 months.
Recommendations for caring for the problem area are quite simple:
•protect the wound from compression and mechanical damage;
•change the bandage regularly (depending on the stage of healing and type of bandage);
•at the granulation stage - use dressings that accelerate healing.
Panthenol
“Panthenol” is found in many home medicine cabinets, since it is a universal drug for both adults and children. When Panthenol is applied to the wound area, pantothenic acid is formed, which activates the restoration of tissue cells. You can buy “Panthenol” not only in the form of an ointment, but also in the form of a cream and spray. Panthenol spray is excellent for treating burns, as it forms a protective film on the skin - protecting, cooling and analgesic. The positive effect of using this wound-healing ointment occurs instantly; it can be used by pregnant and lactating women. The only drawback of this product is the relatively high cost.
Panthenol
JSC Pharmstandard-UfaVITA, Russia
For oral and local use: inflammatory diseases of the oral cavity, nose, larynx, respiratory tract (including after tonsillectomy), gastric mucosa, paresthesia in neurological diseases, treatment of defects of the uterine pharynx mucosa.
For parenteral use: postoperative intestinal atony, paralytic ileus, pantothenic acid deficiency in malabsorption syndrome. For external use: wounds and burns; dermatitis, abscesses, boils, bedsores, diaper rash; treatment and prevention of cracks and inflammation of the nipples of the mammary gland during lactation; care for infants. from 27
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Recommendations of an oncologist at the Dawn Clinic on skin cancer
The Oncology Department of the Rassvet Clinic provides the full range of diagnostics of tumor lesions of the skin, including biopsy and modern pathomorphological diagnostics. In the surgical department of minor oncology, it is possible to carry out surgical treatment using various types of plastic defect replacement.
We also work in partnership with a radiation therapy center, which allows us to provide modern radiation therapy techniques.
With a widespread process, modern chemotherapy and targeted therapy are possible. Treatment can be carried out even in very weakened patients, and our team of specialists provides all necessary accompanying therapy.
Additional recommendations from a doctor at the dawn clinic for the prevention of skin cancer
Since many forms of skin cancer are associated with ultraviolet exposure, a number of measures are recommended to reduce it:
- Use sunscreen. Ultraviolet radiation is a proven human carcinogen. Regular daily use of sunscreen SPF 15 or higher reduces the risk of developing skin cancer by approximately 40%.
- Use a sunscreen with broad-spectrum UVA/UVB protection, applied as directed (30 minutes before sun exposure, reapplied every 2 hours after swimming or sweating).
- Wear protective clothing: long-sleeved shirts, trousers and wide-brimmed hats.
- Avoid visiting a solarium. Those who ever sunbathed indoors had a 67% higher risk of developing squamous cell carcinoma and a 29% higher risk of developing basal cell skin cancer.
Author:
Absalyamov Ruslan Ildarovich oncologist
Solcoseryl
A very effective wound healing ointment that is suitable for both skin and mucous membranes. "Solcoseryl" restores damaged skin cells after burns and frostbite. The drug is based on deproteinized hemodialysate; Solcoseryl can be applied to the mucous membranes of the nose, mouth and external genitalia. It is necessary to distinguish between “Solcoseryl ointment” and “Solcoseryl gel”. These drugs are not interchangeable, so be sure to check with your doctor which one is right for you. Solcoseryl ointment heals deep and weeping wounds, improves metabolic processes in tissues, and reduces pain. The only drawback of this drug is that it has no antimicrobial effect.
Solcoseryl
Solko Basel, Switzerland
Solcoseryl is an activator of metabolism in tissues.
It is a deproteinized hemodialysate of the blood of healthy dairy calves. Solcoseryl increases reparative and regenerative processes, promotes activation of aerobic metabolic processes and oxidative phosphorylation, increases oxygen consumption in vitro and stimulates glucose transport into cells under hypoxic conditions and into metabolically depleted cells, increases collagen synthesis (in vitro), stimulates proliferation and migration cells (in vitro). from 172
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