Evolution of the complex treatment of purulent diseases of the hand including laser irradiation (a review)

The given article is a review on the techniques developed for treating purulent disease of fi ngers and hands. This pathology accounts for a considerable part of all pathologies with which patients seek medical care. A high incidence of the disease is determined by a wide range of reasons. Not infrequently, patients come to hospitals after their outpatient treatment, and as a result of long-lasting pathological process, they have to undergo disabling surgeries leading to the loss of a fi nger or even a hand what worsens this problem because of the economic factor. Over the years, medical care for such patients has been constantly developing. Radical changes have taken place not only in the surgical sphere, but also in preoperative one, in postoperative management and in rehabilitation. The technique of treating wounds under sutures with putting a drain-washing system (DWS) has practically become a classical method of choice for managing phlegmons and panaritia. However, like with any other method, there is a number of medical contraindications to it, and, as before, surgeons must treat purulent wounds in fi ngers and hands using open technologies. In addition, results after DWS are often unsatisfactory. For many years, researchers are looking for new approaches to improve not only outcomes of patients’ surgical care but also postoperative management of wounds. Researchers who use laser radiation in their work have repeatedly demonstrated positive results when treating patients with laser light. Highintensity laser irradiation is widely used in medicine; in purulent surgery, it is used as a scalpel for performing necrectomy. Laser light applied for necrectomy signifi cantly improves wound process, accelerates wound healing, promotes early cleansing of the wound defect from fi brin detritus and exudate. Photodynamic therapy (PDT), which has found wide application in oncology, currently is actively used in purulent surgery too because of good outcomes. PDT shortens wound healing, promotes early granulation and formation of soft scars as well as it has the antimicrobial effect at wounds. However, there are very few studies on the application of laser light in patients with purulent diseases of the hand what has impelled the researchers to make trials on laser light and PDT application in the complex treatment of purulent diseases of the hand.

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