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35 – 43 °C HILOTHERAPY® For tissue conditioning in cases of large-area dissection or flap-plasty
HILOTHERAPY® Calido Our heat application solution with single-degree precision temperature
The HILOTHERM Calido device was specially developed for local application of heat as part of HILOTHERAPY®.
HILOTHERAPY® with the HILOTHERM Calido device makes it possible to apply heat locally for pre-conditioning and/or post-conditioning in cases of potential (or actual) critical blood circulation. This state comes about primarily due to surgical interventions on the body's outer surface, as large-areas of tissue transfer or separation of tissues from underlying tissues (e.g. as part of flap-plasty) can negatively impact blood circulation to skin and muscles. Pre-conditioning of tissues with local heat application at approx. 35 – 43 °C leads to a significant improvement in wound healing and survival of any flap-plasty.
The roll of vascular changes (increase in vessel diameter and number of vessels)
Tissue pre-conditioning (prior to tissue dissection) using local application of heat leads firstly to dilation of blood vessels immediately following heat application (maintaining capillary circulation in the areas threatened by critical ischaemia), and secondly to an increase in the ischaemic tolerance (the capacity of tissues to tolerate a restriction in circulation).
Tissue post-conditioning (following tissue dissection) with local application of heat leads to better maintenance of perfusion in the threatened tissue regions, particularly on the capillary level.
In both cases, a constant application of the desired temperature must be ensured. In the ideal case, the physical stressor should be maintained within the so-called supra-physiological (or, sub-lethal) range, which for application of heat is between 41 - 43°C. On the basis of these findings, the HILOTHERM Calido treatment device was designed for localised application of heat in this exact temperature range.
As a comparative study has shown, protection of tissues is particularly apparent when heat is applied on repeated occasions from approx. 18 hours before surgery (generally on the evening prior to the intervention).
Three 30-minute heat-treatment cycles with a temperature of 43°C, each separated by a passive cooling phase at room temperature, have proven to be a particularly effective protocol.
Following surgery, the heat can be applied on the very same day, and applications continued on a daily basis thereafter. Repeated applications are especially recommended and should certainly be carried out in the first 3-5 days following surgery as reduced blood circulation to the tissues during this period may be associated with necrosis (tissue death). The objective of HILOTHERAPY® is to achieve improved arterial flow through application of warmth (which causes the vessels to dilate), as well as improved venal drainage (flow back to the heart), so that tissue necrosis can be prevented.
Using the device
The precise heat application is made possible by using water. The water is heated in our specially-designed treatment device with degree-exact precision and maintained constantly at this value. The temperature stability that is medically indicated is guaranteed in this way, both for short treatment sessions and applications lasting as long as several days. To make application of the treatment possible on all of the various different parts of the body, mouldable cuffs were developed through which water circulates. These are available in different shapes and sizes and so can be perfectly adapted and applied to the body region to be heated. Water is heated to the desired temperature and is circulated around the cuffs, ensuring a constant and uniform heat application to the body’s tissues.
Prof. Dr. med. Yves Harder
Department head for Plastic, Reconstructive and Aesthetic Surgery (EOC)
Ospedale Regionale di Lugano (ORL) / Sede Italiano (OIL) / Via Capelli /CH-6962 Viganello – Lugano / Switzerland
“Local application of heat using mouldable polyurethane cuffs applied to the body region due to be operated on has proven its benefits time and time again. The uniform application of heat is reported by patients as being far more comfortable than localised cooling. In all the applications to-date, there have been no side effects. Local redness caused by increased local blood flow to the skin will clear up by the day following treatment at the latest.
“HILOTHERAPY Calido” - applied locally prior to surgery - significantly reduces incidence of both wound healing disorders and skin necrosis in skin and muscle tissue in critical circulatory situations.”