Домой Бородавки Удаление подошвенных бородавок жидким азотом — особенности и этапы проведения

Удаление подошвенных бородавок жидким азотом — особенности и этапы проведения

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Эффективное удаление подошвенных бородавок при помощи жидкого азота

Возникающие на поверхности подошвы бородавки причиняют массу неудобств при ходьбе и часто сопровождаются болью. Удалить их можно с помощью различных медицинских методик, одной из которых является криодеструкция.

Удаление подошвенных бородавок жидким азотом пользуется популярностью в связи с большой эффективностью и минимальными последствиями. В большинстве случаев после такой процедуры характерные высыпания на стопе больше не появляются.

Особенности метода

Основная особенность удаления подошвенных бородавок при помощи криодеструкции кроется в действующем факторе — жидком азоте. В естественном состоянии азот является газообразным веществом, но при температуре –196 °С способен перейти в жидкую форму. В обычных условиях такое невозможно, поэтому его охлаждают искусственным образом с помощью специальных установок на заводах.

При терапии бородавок жидкий азот воздействует на измененные клетки кожи и приводит к замораживанию. В результате происходит расширение внутриклеточной воды, провоцирующей разрыв клеток с последующим отмиранием. При этом здоровые клетки не страдают, поскольку способны противостоять действию азота. Постепенно отмершие клетки заменяются здоровыми, и место удаления полностью заживает. Шрамы после такого воздействия остаются достаточно редко.

Важно! Проведение криодеструкции редко сопровождается болью, предоставляет возможность эффективно удалять подошвенные образования больших размеров и быстро выполняется. А воздействие сверхнизких температур приводит к прекращению микроциркуляции и лимфотока в месте воздействия, что предотвращает дальнейшее распространение папилломавируса.

Существует два основных способа применения жидкого азота при расположении бородавок на подошвенной поверхности стопы — аппаратный и ручной. В первом случае используется специальный аппарат под названием криодеструктор, во втором — простая палочка с ваткой или аппликатор. У каждого способа имеются свои преимущества и недостатки. Остановимся подробнее на каждом из них.

Аппаратный метод

При проведении процедуры удаления новообразований аппаратным методом происходит воздействие жидкого азота на подошвенные бородавки с помощью криодеструктора. Специалист располагает наконечник прибора (диаметр подбирается в соответствии с размером бородавки) непосредственно над патологическим элементом на короткое время — от 30 секунд до 2 минут. Это обеспечивает кратковременное холодовое воздействие на пораженные ткани.

Азот приводит к мгновенному замораживанию патологического образования с последующим разрушением и отмиранием. Воздействие сверхнизких температур приводит к замерзанию цитоплазматической и межклеточной жидкостей, а клеточные структуры и мембрана бородавки повреждаются. Происходит некротизирование этой области и отграничивание от живых тканей демаркационной линией.

По истечении времени воздействия бородавка становится плотной, холодной, белой и нечувствительной, и впоследствии должна отвалиться. Глубина и эффективность деструкции напрямую зависят от скорости воздействия. Под участком некроза (корочкой) постепенно формируется новый эпителий, вытесняющий некротизированные ткани. Через некоторое время (от 1 до 3 часов) на этом месте развивается отек с локальной гиперемией.

Впоследствии появляются характерные пузырьки, заполненные серозной жидкостью. Иногда они имеют почернелый вид из-за содержащейся в них крови. Если время воздействия было коротким, образования пузырьков не происходит. Некроз сохраняется от 2 недель до месяца, после чего сменяется здоровыми тканями в виде светлого пятнышка. Окончательное восстановление занимает от 3 месяцев до полугода.

Преимущества

Аппаратная криодеструкция пользуется популярностью у докторов и пациентов благодаря большому количеству преимуществ:

  1. Хороший косметологический эффект. Поскольку здоровые клетки хорошо противостоят азоту, и он воздействует непосредственно на бородавку, процессы заживления происходят быстро. Они редко приводят к образованию рубца, который бывает практически незаметен.
  2. Отсутствие крови. Воздействие низких температур снижает вероятность кровотечений, а вместе с ним риски повторного распространения вируса и опасность проникновения инфекции.
  3. Активация иммунного ответа. Характерной особенностью криодеструкции является активация иммунитета в ответ на экстремально низкую температуру. В результате происходит массовое образование цитотоксических клеток и антител, имеющих направленное действие против папилломавируса. Они долго циркулируют в организме, способствуют выработке клеток памяти, которые при следующей встрече с папилломавирусом будут активно защищать организм.
  4. Редко сопровождается болью. Проведение процедуры обычно безболезненное, поскольку холод выполняет функцию обезболивания. Болевые ощущения в основном возникают при глубоком расположении бородавок.
  5. Не влияет на общее состояние. Воздействие жидкого азота на высыпания никак не отражается на самочувствии пациентов.

Важно! Процедура аппаратной криодеструкции может проводиться и у детей. Она выполняется быстро, имеет минимум противопоказаний и не требует дополнительной подготовки со стороны пациента. После удаления папилломы ранку можно мочить без опасения воспаления и задержки процессов восстановления.

Этапы проведения

Выведение подошвенных бородавок с помощью криодеструктора проводится за один или несколько сеансов, в зависимости от величины наростов и их количества.

Каждый сеанс включает в себя несколько этапов:

  • устройство пациента на удобной кушетке в определенной позе: обеспечивает специалисту полный доступ к образованию и исключит вероятность резких движений во время манипуляций;
  • обработка смягчающим гелем: выполняется с целью размягчения верхнего рогового слоя образования и более глубокого проникновения азота;
  • выполнение обезболивания: проводится при большом размере, глубоком расположении бородавок, повышенной чувствительности и в детском возрасте;
  • непосредственное воздействие жидкого азота на бородавку: проводится за счет прикладывания аппликатора криодеструктора с определенным нажимом, который помогает прижечь папиллому; при отсутствии обезболивания может сопровождаться болью, интенсивность которой зависит от глубины образования и порога чувствительности.

Далее специалист делает паузу, которая необходима для оценки эффективности. Через 1–2 минуты участок воздействия оттаивает, и становится понятно, насколько глубоко подействовал азот. При необходимости проводится повторный сеанс.

Пациент во время процедуры редко испытывает болевые ощущения, особенно после обезболивания новокаином или лидокаином. Иногда ощущается небольшое жжение или покалывание. А после образования корочек пациент нередко испытывает чувство зуда, свидетельствующее о процессах заживления.

Ручная методика

Воздействие жидким азотом на подошвенные бородавки ручным методом практически не отличается от аппаратного. Единственная разница заключается в замене аппликатора криодеструктора палочкой с ватой или аппликатором, которые опускают в емкость с жидким азотом, после чего прикладывают к наросту.

Эффективность ручного метода несколько ниже по сравнению с аппаратной методикой, особенно при слишком глубоком расположении подошвенных бородавок. Поэтому его чаще рекомендуют при поверхностных высыпаниях. Кроме того, процедура ручной криодеструкции может быть проведена дома, без посещения медицинского учреждения.

В этом случае она имеет несколько характерных отличий:

  • используется не жидкий азот, а аналогичная субстанция в виде специально созданного химического соединения;
  • температура охлаждения составляет всего -55–59 °C;
  • для полного удаления образований всегда требуется несколько сеансов.

В домашних условиях используются различные медицинские препараты, которые можно купить в аптеке. Они отличаются надежностью и безопасностью. Вместе с ними в комплекте часто находится дозатор, позволяющий отмерить точное количество действующего вещества. В отличие от аппаратного метода, на который отводится не более 15 минут, ручной может занять больше времени и всегда требует нескольких повторений. Для защиты окружающих тканей рекомендуется обклеить кожу вокруг бактериологическим пластырем.

Важно! Перед покупкой и использованием любого препарата рекомендуется проконсультироваться со специалистом и внимательно изучить приложенную инструкцию. Особенно в тех случаях, когда применение средства планируется у детей.

Правильный уход после проведения процедуры

Специального ухода за ступней после выполнения криодеструкции не требуется, поскольку рана защищена формирующимся струпом. Образующиеся пузыри вскрывать строго противопоказано. Это приведет к нарушению процессов заживления. Можно наклеить на ранку любой антисептический пластырь с марлевой или тканевой основой. Рекомендуется не перегружать ноги и по возможности меньше опираться на стопу до тех пор, пока все признаки отека не спадут и пузыри не исчезнут.

Доктора рекомендуют проводить двукратную обработку пузырей салициловым спиртом (2% раствор), который будет оказывать подсушивающее действие. Для этой цели подойдет и перманганат калия. Необходимо обрабатывать место аппликации до тех пор, пока не начнутся процессы шелушения, что происходит примерно через 1 неделю. При самостоятельном вскрытии пузырей можно наложить стерильную повязку.

Для предупреждения попадания инфекции рану можно обработать водным раствором Мирамистина или Хлоргексидина. После мытья ног или приема ванны рекомендуется пользоваться личными банными принадлежностями и полотенцем. Это необходимо делать во избежание распространения вируса, способного выделяться в окружающую среду на этапе заживления.

Недостатки криотерапии

Как и любой лечебный метод, криотерапия, независимо от выбранного метода (аппаратный или ручной), имеет определенные недостатки. Один из них — необходимость большого количества времени для полного заживления места воздействия после прижиганий азотом. Иногда специалист выбирает другой метод лечения, поскольку полное удаление глубоких образований на подошве стопы с помощью жидкого азота является трудновыполнимым.

Еще один недостаток кроется в отсутствии возможности взять биопсийный материал во время проведения криодеструкции. При подозрении на опухолевое происхождение бородавки специалисту придется использовать другой метод. К относительным недостаткам причисляют список противопоказаний к выполнению криодеструкции. Процедура не может проводиться у ребенка до 4 лет, беременных и кормящих женщин, а также людей с сахарным диабетом, высоким артериальным давлением и нарушениями периферического кровообращения.

Также существуют определенные сложности в расчете глубины проникновения азота. При излишне глубоком воздействии процедура может привести к повреждениям здоровой кожи, возникновению рубцов и ожогов. А при небольшой глубине заморозки понадобится повторное проведение. В некоторых случаях появляются боли, покраснение, вздутие кожи в месте воздействия. А иногда возникают участки гипо- или гиперпигментации. Большая часть из всех перечисленных последствий относится в основном к аппаратному, более глубокому, методу лечения.

Популярные средства на основе жидкого азота

В аптеках продается несколько препаратов на основе жидкого азота, которые можно использовать для проведения процедуры криодеструкции в домашних условиях. Среди них самыми популярными считаются Криофарма для стоп и Вартнер Крио. В упаковке каждого препарата находится металлический флакон с действующим составом, аналогичным жидкому азоту.

К нему приложено несколько одноразовых аппликаторов (обычно 12) со специальным держателем. Перед покупкой препарата необходимо посоветоваться с лечащим врачом, а во время использования строго следовать приложенной инструкции. Но нужно помнить о том, что любой метод криодеструкции не способен удалить папилломавирус из организма. Для этого необходимо назначение противовирусной терапии.

Процедура прижигания подошвенной бородавки с помощью жидкого азота уменьшает риски повреждения окружающих здоровых тканей, возникновения кровотечений и воспалительных процессов инфекционного характера. Она может проводиться в детском возрасте и редко сопровождается отдаленными последствиями. Поэтому криодеструкцию часто рекомендуют специалисты и выбирают пациенты. После ее завершения ткани быстро восстанавливаются, а поверхность стопы вновь становится гладкой и ровной.

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