DEVICE AND METHOD FOR UV ANTISEPSIS
20220339467 · 2022-10-27
Assignee
- UNIVERSITÄTSMEDIZIN GREIFSWALD (Greifswald, DE)
- CHARITÉ - UNIVERSITÄTSMEDIZIN BERLIN (Berlin, DE)
- TECHNISCHE UNIVERSITÄT BERLIN (Berlin, DE)
- FERDINAND-BRAUN-INSTITUT GGMBH, LEIBNIZ-INSTITUT FÜR HÖCHSTFREQUENZTECHNIK (Berlin, DE)
Inventors
- Martina Meinke (Berlin, DE)
- Jürgen Lademann (Fürstenwalde, DE)
- Axel Kramer (Greifswald, DE)
- Michael Kneissl (Berlin, DE)
- Tim WERNICKE (Berlin, DE)
- Ulrike WINTERWERBER (Berlin, DE)
- Sven EINFELDT (Berlin, DE)
Cpc classification
A61N2005/063
HUMAN NECESSITIES
A61N5/0624
HUMAN NECESSITIES
International classification
Abstract
The invention relates to a device and a method for UV antisepsis, in particular for intracorporeal in vivo UV antisepsis on the human and animal body in the event of colonization with multiresistant pathogens (MRPs) such as methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE). The device comprises a light emitting diode chip, LED chip, configured to emit radiation in the UVC spectral range, wherein the LED chip forms a light emitting diode, LED, with a package; a spectral filter element set up to limit the radiation emitted by the LED chip substantially to wavelengths below 235 nm; and an optical element for directional emission of the radiation emitted by the LED.
Claims
1. A device for UV antisepsis, in particular on skin, mucous membranes, wounds, in body cavities and on surgically exposed tissues and organs, comprising: a light-emitting diode chip (LED chip), configured to emit radiation in the UVC spectral range, wherein the LED chip forms a light-emitting diode (LED) with a package, wherein the LED chip has been grown on a substrate of bulk AIN or sapphire; a spectral filter element set up substantially to limit the radiation emitted by the LED chip to wavelengths below 235 nm by means of largely angle-independent spectral filtering; wherein the spectral filter element is integrated as an intrinsic Bragg reflector with a plurality of Al.sub.xGa.sub.1−xN/Al.sub.yGa.sub.1−y N layer pairs with x≠y into an epitaxial layer structure of the LED chip; or wherein the spectral filter element is integrated as an AlO.sub.x/SiO.sub.2− DBR or as a DBR filter with HfO.sub.2, Ta.sub.2O.sub.5, CaF.sub.2, MgF.sub.2, Ga.sub.2O.sub.3 or AIN as dielectric into the package of the LED or is applied to the LED chip, wherein the shape of the spectral filter element is adapted to the emission characteristics of the LED; or wherein the spectral filter element is obtained as an angle-independent bandpass filter via excitation of surface plasmons or a Fabry-Pérot filter concept; and an optical element for directional emission of the radiation emitted by the LED, wherein spatial uniformity of the radiant power is achieved by adapting emission to an area to be irradiated by means of the device.
2. The device according to claim 1, wherein the spatial emission characteristics of the LED are determined by the width, composition and distortion of the band structure of the LED chip, the external geometry of the LED chip or by reflectors, apertures, lenses and/or shaped potting integrated into the package.
3. The device according to claim 1, wherein the device takes the form of a large-area radiator and intensity is homogenized over the area to be irradiated by a flexible arrangement of the LEDs and the use of reflectors in the large-area radiator.
4. The device according to claim 1, wherein the optical element comprises a lens, a light pipe or an optical fiber.
5. The device according to claim 1, wherein the optical element is replaceable.
6. A medical pad for UV antisepsis, comprising a plurality of devices according to claim 1 arranged to form an array, wherein the devices are arranged on a flexible or a rigid support element.
7. The pad according to claim 7, wherein the support element comprises a flexible or rigid spacer element configured to establish a distance between the devices arranged to form an array and the surface when placed on a surface to be decolonized, wherein the spacer element allows irradiation of the surface with the radiation emitted by the devices.
8. The pad according to claim 8, wherein the spacer element is replaceably connected to the support element.
9. The pad according to claim 7, wherein at least one monitor diode is integrated into the pad as a detector for monitoring the radiant power irradiated onto the surface to be decolonized.
10. A method for UV antisepsis comprising irradiating a surface to be decolonized using a device according to claim 1.
11. The device according to claim 1, wherein the LED chip is driven for pulsed emission with pulses of a duration of up to 1 μs.
Description
[0047] The invention is explained below with reference to exemplary embodiments and on the basis of the accompanying drawings, in which:
[0048]
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[0050]
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[0055]
[0056] The width of the emission spectrum of a UV LED can likewise be influenced by the heterostructure design as well as a variation in the material composition and in the individual layer thicknesses. The adjustability of the emission wavelength of the UV LED makes it possible to optimally adapt the emission spectrum of the UV LED to the respective application. Therefore, according to the invention, for example, the best possible compromise can be established between the emitted power of the UV LED, the antiseptic effect achieved and the avoidance of damage to the irradiated tissue. As the wavelength decreases, the power and efficiency of the UV LEDs typically fall as well, i.e. the antiseptic effect becomes less or the irradiation time must be increased to achieve the same dose. However, at shorter wavelengths, UV radiation does not penetrate as deeply into the tissue surface, i.e. the damage is less. The power and efficiency of UV LEDs increase noticeably as wavelength increases, i.e. the antiseptic effect becomes stronger. However, the UV radiation penetrates deeper into tissue surfaces at longer UV wavelengths, meaning damage is greater. In addition, the typical emission spectrum of a UV LED also includes a longer-wavelength component that could potentially have a damaging effect on the irradiated tissue, in particular wavelength components in the range >240 nm that can penetrate into deeper skin layers.
[0057]
[0058] The reflectance spectrum shown on the left was calculated using the transfer matrix method for perpendicular incidence. The spectral filter element consists of 10 AlO.sub.x/SiO.sub.2 mirror pairs forming a DBR (distributed Bragg reflector). For corresponding refractive indices and thicknesses for the uniform layers, the following values were assumed for AlO.sub.x n=1.85 and d=35.16 nm and for SiO.sub.2 n=1.46 and d=44.52 nm. The reflectivity of the AlO.sub.x/SiO.sub.2-DBR is minimal at 233 nm (R=0.7%) and increases very rapidly for longer UV wavelengths (i.e. these wavelengths are filtered out). At a wavelength of 240 nm, reflectivity is already R=82% and at 250 nm, R=97%.
[0059] The slope of the stopband (DBR) can be adjusted by the number of mirror pairs, i.e. using more mirror pairs results in a steeper stopband. In addition, the width of the stopband (DBR) can be controlled by the choice of individual dielectrics. A higher difference in the refractive index of the dielectrics broadens the stop band (DBR).
[0060] The diagram on the right shows the emission spectrum of a typical UV LED in logarithmic representation with and without the spectral filter described above. For the UV LED without filter (dashed curve), the peak wavelength in this example is 231.8 nm and the half-value width is 11.9 nm. By integrating a filter element as described above, the longer-wavelength UV component of the emission spectrum can be significantly reduced without noticeably reducing the spectral power in the short-wavelength UV range. The peak wavelength of the UV LED with the filter (continuous curve) shifts slightly to 232.2 nm, and the half-width decreases significantly to 7.7 nm. In particular, the longer-wavelength UV component with wavelengths >240 nm is strongly reduced.
[0061] The width of the UV LED emission spectrum can also be influenced by the heterostructure design as well as a variation in the material composition and in the individual layer thicknesses.
[0062]
[0063]
[0064]
[0065] In
[0066] Thus, the described module represents only a multi-LED package, the underlying principle being the same as in
[0067] Regarding the spectral filter element, it should be noted that the FWHM half-value width of the emission spectra of UV LEDs (FWHM=full-width half-maximum) generally ranges between 5 nm and 25 nm, typically 10-12 nm. The integrated emission power between 210 nm and 235 nm is just under 300 μW and the total power over all wavelengths is about 475 μW. To avoid tissue damage from deeply penetrating UV light, the longer wavelength components (>235 nm) should as far as possible be eliminated from the spectrum. As described above, this can be done in particular by integrating a spectral filter element as an optical short-pass filter (short-pass filter with respect to wavelength) into the module or directly into the UV LED chip (e.g. onto the free substrate side) or the package. However, the spectral filter element can also be integrated into an LED module as an additional element. Such an optical short-pass filter can be obtained, for example, as a DBR (distributed Bragg reflector) using a layer stack of UV-transparent layers with different refractive indices. For this purpose, in particular, a plurality of Al.sub.xGa.sub.1−xN/Al.sub.yGa.sub.1−yN layer pairs (x≠y) can be integrated into the epitaxial layer structure of the UV LEDs. Furthermore, layer pairs of dielectrics with different refractive indices can be integrated into the rear of the substrate or into the package (e.g. on a quartz cap). Other dielectrics suitable for the fabrication of DBR filters include for example HfO.sub.2, Ta.sub.2O.sub.5, CaF.sub.2, MgF.sub.2, Ga.sub.2O.sub.3 or AIN. The spectral properties of the short-pass filter can be optimized to the respective application, in particular, by selecting suitable materials and the thickness and number of DBR mirror layers.
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[0075] The cap can preferably take the form of a hemisphere made of e.g. UV-transparent silica glass or silicone. The individual layers of the spectral filter element 14 can be applied directly to the curved surface of the cap. This ensures that the UV light rays from the LED chip 12 are mostly perpendicular to the DBR mirror layers and that the cut-off wavelength of the spectral filter element 14 does not change with the emission angle. Another advantage is that such a configuration improves light extraction from the UV LED, so enhancing efficiency and output power. Uniform coating of the hemispherical cap can be achieved, in particular, by means of a suitable holder in a coating installation or by rotating the cap during the coating process.
[0076] If a plurality of UV LEDs 10 (or LED chips 12) corresponding to
[0077] The results of investigations into the radiation and dose dependence of UV antisepsis on excised skin samples are additionally indicated below.
[0078] The investigations were performed using a frequency-doubled argon ion laser (LEXEL laser, 95-SHG) at a wavelength of 229 nm. Excised human skin after scar removal was available for this purpose. The sample was freshly taken the day before the experiment was performed. The skin was irradiated with 0.2 mW/cm.sup.2 for 5 minutes and for 30 minutes. The power was determined using a power meter. The corresponding radiation doses were 60 mJ/cm.sup.2 and 300 mJ/cm.sup.2. In addition, the 300 mJ/cm.sup.2 was applied by 1 mW/cm.sup.2 for an irradiation time of 5 min. UVB radiation at the same doses was used as a positive control. An unirradiated sample served as a negative control.
[0079] One 4 mm punch was taken from each sample and transferred to an embedding cassette. The tissue was fixed using a 4% formaldehyde solution. The samples were taken to the laboratory for analysis on the same day. Paraffin sections (thickness 1-2 μm) were prepared from the fixed tissue samples and stained with hematoxylin and eosin to allow differentiation between the different tissue structures. Typical DNA damage caused by UV radiation, known as cyclobutane-pyrimidine dimers (CPDs) and 6-4 photoproducts (6-4PP), was then detected using appropriate antibodies. CPDs constitute approximately 70% to 80% of UV-induced DNA damage, the remainder being 6-4 PPs and the isomeric forms or Dewar photoproducts thereof. DNA modification caused by both UVC and UVB irradiation should be prevented, especially in the basal membrane. Significant staining of the positive control compared to the actual samples clearly showed that radiation at 229 nm, unlike UVB radiation, produces no to few CPDs in the cells. On magnification, “CPD cells” can be found in the upper epidermis at 300 mJ/cm.sup.2. The second irradiation at 300 mJ/cm.sup.2 does not reveal any such cells. With UVB irradiation, on the other hand, CPD damage occurs very clearly and intensively up to the upper layers of the dermis. Furthermore, no 6-4PP damage was found with UV irradiation at 229 nm regardless of the radiation dose. In contrast, such damage is very pronounced with UVB irradiation.
[0080] It was thus possible, with these investigations, to successfully demonstrate that little to no DNA damage to excised skin samples occurs with UV irradiation at 229 nm, and even high doses of 300 mJ/cm.sup.2 cause only very superficial damage to the living epidermis.
[0081] Furthermore, microbial reduction investigations were conducted on pig ears. The following antiseptic exposures were compared on marked areas of a pig's ear: [0082] ethanol-based skin antisepsis (AHD 2000), exposure time 1 min, [0083] UVC 60 mJ/cm.sup.2, (0.2 mW/cm.sup.2, 5 min), [0084] UVC 300 mJ/cm.sup.2 (0.2 mW/cm.sup.2, 30 min), [0085] UVC 300 mJ/cm.sup.2 (1 mW/cm.sup.2, 2.5 min) and [0086] untreated control.
[0087] In the untreated control, only 15 colony-forming units were detectable in the sample volume of 1 ml due to the low colonization density. All the antiseptic treatment modes completely eliminated skin flora with no apparent tissue damage. This demonstrated the microbicidal effectiveness of the intended radiation range.
LIST OF REFERENCE SIGNS
[0088] 10 LED [0089] 12 LED chip [0090] 14 Spectral filter element [0091] 16 Package [0092] 18 Optical element [0093] 30 Substrate [0094] 32 Active layer [0095] 34 Contacts [0096] 36 Submount [0097] 40 Housing [0098] 42 Circuit carrier [0099] 50 Light pipe [0100] 52 Monitor diode [0101] 54 Glass fiber [0102] 56 Cladding [0103] 100 Device [0104] 110 Support element [0105] 112 Spacer element [0106] 114 Monitor diode [0107] 116 Reflector [0108] 200 Pad [0109] A Distance [0110] O Surface