The Cold Plasma Coagulator
K.S.Avramenko, O.B.Baranov, E.P.Kopenkin
The cold plasma coagulator (CPC) is developed on the basis of the
latest achievements of the defense industry in the field of plasma
devices. CPC can work autonomously. The first devices of this kind
were created in 1994.
The principle of work is based on getting a cold plasma torch. No
significant quantities of heat are registered when CPC is used for
coagulation of tissues. That is why thermal injuries are 0.1-0.2 mm
thin. It gives an opportunity to use the device in a large scale in vet
clinics including ophthalmologic operations. Healing of injuries is
much faster than after treatment with other types of coagulators.
CPC is a monopolar device and it helps avoid flowing of current
through tissues and corresponding electrolysis of them when
conventional electric coagulators are used. Coagulation in this case
is done with a plasma torch. There is no contact between the
electrode and the treated surface. This fact provides additional
protection of injuries from infections. The "no-contact" character of
work helps avoid welding of tissues to the coagulating electrode
resulting in a break of tissues and new hemorrhage. It is especially
important when operations on parenchymatous organs and eyes are
done.
Monopolar character of CPC-s work is achieved with the idea to
use the principle of quasistatic discharges, which has nothing to do
with the conventional electric current. The plasma-generating head
creates 500-1000 electrostatic discharges per second, which are
perceived with an eye as a small plasma brush.
Static charges have a property to stay on the surface of conductors
and not to penetrate inside. This is why there is no deep
electrothermal injury of tissues under the treated surface. A layer of
carbon 0.1 mm thin is formed immediately on the treated surface
when plasma arch appears between the needle and the tissue. It
additionally protects the tissues underneath from thermal injury. It
means that in this process layers of tissue 0.1 mm thin are removed
from the surface with simultaneous welding of vessels. The needle
electrode is made of silver and in the process of coagulation the
needle-s material is partially pulverized. Ions of silver coming into the
wound change the electric potentials of the injured surface for a
long time stimulating processes of regeneration and additionally
disinfecting it. The plasma torch ionizes the air and forms big quantity
of ozone. If a burning match or lighter will be taken close to an
electrode of working coagulator the ozone wind generated by
plasma will extinguish the fire.
Such quantity of ozone causes complete disinfecting of the wound
and also influences positively healing of eczema.
CPC can be used to remove papillomae, condillomae, tattoos, to
cure animals, to cure patients who have venereal sarcoma,
tendovaginitis, different dermatological diseases (wet eczema,
dermatomicoses and eye diseases, to treat post-operational and
infected wounds, to ligate blood vessels without ligatures welding
walls of vessels.
The coagulator has no analogs concerning the quality of treatment of
tissues and stopping hemorrhage in cases of break in
parenchymatous organs and surgical operations on them.
The device was awarded with two gold medals in Eureka
Exhibition-1997 (Brussels, Belgium) and gold medal of All-Russia
Exhibition Centre (Moscow). Other types of coagulators existing
now (laser, plasma and electric coagulators) weigh from 2 to 300
kg, need argon and from 900 to 5000 W of electric power, have
water cooling. Gas necessary for one operation costs from $2 to $5.
At the same time CPC weighs 500 g, it can work from
accumulators, does not need gas and water supply.
Technical characteristics of the portable CPC.
Voltage of the autonomous source of power, V |
6-12 |
Maximum of used power, W |
18 |
Maximum of output power, W |
10-12 |
Time of work without interruptions, h |
|
from accumulators inside |
1 |
from electric network |
no limits |
Weight with accumulators, kg |
0.5 |
The CPC was used in 1500 operations which were held during last
three years in 16 vet clinics of Moscow and St.Petersburg. methods
to use CPC to cure animals were also developed by specialists from
vet stations of Dzerzhinsk, Zelenograd and Skryabin Vet Academy.
When dogs (first of all belonging to the breeds of lop-eared dogs
like cocker spaniels and setters) have chronic external otitis with
obliteration of external acoustic meatus (verrucous dermatitis) it is
accompanied with vegetations of tumor-like dermal neoplasms on
the internal surface of acoustic meatus and floor of the auricle, with
discharge of catarrhal purulent exudate of yellow and grey colour
and unpleasant harsh smell.
Use of conservative and surgical methods like palliative operation,
antibiotic therapy, etc., is laborious. It is so because instrumental
approach to an affected acoustic meatus and dissection of
neoplasms are accompanied with large dissection of tissues generally
of the auricle floor, deformation of the cartilage, intensive
hemorrhage (due to the fact that there are many big and small blood
vessels in this area). Treatment in the postoperative period is also
not easy because everyday treatments are laborious and very
painful.
Use of CPC to cure verrucous dermatitis excepted necessity to
provide large surgical access to neoplasms in the lumen of external
acoustic meatus. It is very important to have such an access during
operations. Risk of postoperative complications such as facial
paralysis, hemorrhage, disjunction of sutures, development of
fistulas, change of hearing to the worse, etc., disappeared.
Use of CPC to treat animals that have verrucous dermatitis helped
make the postoperative treatment shorter and simpler. Moreover, in
some cases the necessity of postoperative treatment was excluded
completely. Ions of silver discharged from the coagulating needle
due to thermal emission under influence of electrostatic field. Getting
to the wound those ions changed electric potential of the injured
surface for a long time. This effect expedited the regenerative
processes and disinfected the wound.
Thanks to CPC there is no need for deep curettage of the auricle
floor any more. Mechanical cleaning of tissues can be replaced with
thermal atraumatic treatment 0.1 v 0.2 mm deep.
CPC was used for different operations including cavitary and osteal
ones in the Zelenograd vet station.
Preparation of CPC for work took not more than 4 minutes. The
head of the device was disinfected with 0.5% solution of
chlorhexidinbigluconate in 70% solution of spirit (minimum 2-minute
exposition). The needle of the device can be also placed in the
spirituous solution of chlorhexidin. There was no direct contact of
the coagulating head of the device with the treated tissue. The
plasma arch appears when distance between the needle and tissue is
10 mm.
Methods to hold some kinds of operations are to follow.
Operation of castration of tom-cats is standard. Spermatic cord is
prepared together with vessels (internal spermatic arteries and vein)
and ductus diferens. Then hemostatic "Mosquito" forceps are used
(distance is 1-2 cm from each other). CPC should be switched on
cutting/coagulation mode and used for cutting the spermatic cord
together with the vessels and ductus between forceps. CPC will then
be useful in the process of tamponing and treatment of stumps. Then
forceps are removed. Touching the edge of tissue with forceps one
can become sure that there is no hemorrhage any more. Ligature is
not used here. Operation of ovariectomy is standard. Laparotomy
was done along the white line in the unfraumbilical region. The ovary
should be found and raised upon the abdominal cavity and edges of
incisions.
Dissections of the suspensory ligament of the ovary were done with
the CPC in the mode of dissection of tissues. Hemostatic forceps
were superimposed on ovarian artery and vein, on the one side, and
on uterine vessels on the level of the uterine horn-s apex, on the
other side. Stepping back 0.5-0.6 mm from the edge of forceps, a
dissection was done between forceps cutting the ovary off. After the
treatment of the stump with the CPC the forceps were removed.
The ligature was not superimposed.
In some cases when cats have felt fur, the wool-cutting results in
traumatization of skin with deep cuts. Using the CPC it is possible to
turn out without putting stitches or agraffes on skin. Technique of
manipulation is simple. Treating the cavity and edges of wound with
the CPC resulted in double decreasing of wound-s surface. The
capillary hemorrhage was stopped. The healing was taking place
under carbonic crust.
Private doctors can also use this method because sometimes it is not
easy to have immediately at hand a set of sterile instruments for
stitching. Curing a 9-years-old German shepherd dog that had
tendovaginitis it was possible to reach a short-lived therapeutical
effect with the help of antibiotics and corticosteroids. Paquelin
cauterization with the assistance of CPC directly in the region of
pathologic process helped heal the animal.
The CPC could be also of great help for cauterization of papillomae
on the skin. The use of this device is even more efficient in cases of
extensive papillomatosis of the stomatic cavity. Local anesthesia can
be used to remove from skin the benign tumors on limbs. The CPC
was switched on the cutting mode. The tumor was removed at the
base level. Such an operation is exsanguinate and has short duration.
It can be painless if anesthesia is done correctly. Moreover, it can
be done in home conditions.
Such an operation can be classified as a cosmetic one.
When small pets undergo hysterectomy, the stump of the uterus is
treated with iodine solution and then the mucous membrane should
be cleaned. Using the CPC it was cauterized without stitching the
serous membrane (these stitches close the cavity of the uterus
stump). It is also helpful to use the CPC for cutting the ligament of
the uterus. Usually the ligature for stopping the hemorrhage is not
necessary in this case.
The CPC was used in the Skryabin Vet Academy to cure different
eye diseases of dogs and cats, especially keratitis that cannot be
cured with usual methods.
26 dogs that had serpent ulcer of the cornea were observed in an
experiment. Pathology fixed is to follow: blepharospasm, epithelium
defect (erosion of the cornea), lacrimation, photophobia, pericorneal
injection. To cure a dog it was necessary to cauterize the edges of
ulcer one or two times with one-week interval. After that the
sorcoseryl jelly and colbiocyn ointment should be used three times a
day.
20 dogs (German shepherds) who were sick with herpes-virus
hepatitis in a scrofulous form were characterized before the medical
treatment as having moderate spasm of eyelids, insignificant
discharge of serous-mucosal exudate, cornea being uneven,
tuberous, pigmented and pierced with vessels. The treatment
included 1 to 3 times cauterization of the connective tissue, vessels
and pigment with 2-week intervals, subconjuctive injection of 0.5%
novocainic solution, lydasa, dexamethasone and gentamycin 1 time a
week and everyday treatment with prenacyd ointment. Dogs
recovered within the period of 25-35 days. Recidivation was fixed
for several dogs 3-4 months after.
16 dogs of different breeds with punctate keratitis (herpes-virus)
had a macule of roundish form and mother-of-pearl shade with
central or paracentral location. 6 dogs recovered after cauterization
one time per month with following subconjunctival injection of 5%
solution of novocain, lydasa, gentamycin, dexamethasone, glycopin.
Cauterization was done just one time in cases of pigmentary keratitis
characterized with moderate blepharospasm, discharge of yellow
purulent exudate, uneven tuberous cornea with places covered by
dark brown pigment. Some places of the cornea were totally injured
(n=10) and some places were partially pigmented (n=14). Later
colbiocyn, jelly of sorcoceryl were used, dexamethasone, lydasa
and novocain were injected subconjunctivally. Complete clearing-up
of cornea was registered for 3 of 10 dogs with total injury and for
11 of 14 animals with partial pigmentation.
Corneal sequester is one pathologies which results in complete loss
of cats- visual functions and sometimes in perforation of cornea.
Clinical characters are to follow: necrotized corneal part of dark
brown to black colour, blepharospasm, and lacrimation.
Cauterization of edges in initial stage (erosion of cornea) one time in
2 weeks suspended developments of corneal sequester. After that
Complex Immune Protector (CIP) was used as well as jelly of
sorcoceryl and ointment of colbiocyn. Animals recovered within the
period of 2-3 months.
Dermoid of conjunctiva and cornea is a benign neoplasm of skin
components covered with hair. Sometimes it traumatizes the cornea
resulting in hyperemia of conjunctiva, development of keratitis,
ulcers of the cornea and loss of vision.
When dermoid was removed the CPC was used to stop
hemorrhage and cauterize edges of the wound.
CONCLUSION
The CPC can be used to stop both arterial and venous hemorrhage
by welding of vessels without ligation as well as for thermal
separation (cutting) of tissues with simultaneous welding of adjacent
vessels.
However, this procedure is laboured for vessels in fatty tissues.
Dehematizing of the location under treatment is necessary to for
successful welding of vessels. Exarticulation of those vessels out of
adjacent tissues for at least 0.5 cm is obligatory.
The CPC is efficient in cases of keratitis first of all because the
corneal tissues are treated with ions of silver and are ozonied.
Symptomatic treatment gives positive results with such a
background.
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