ROLE OF PLATELET-ENRICHED AUTOPLASMA AND CORRECTION OF LYMPHOUTFLOW IN TISSUE RESTORATION AND REGENERATION IN PATIENTS WITH VENOUS TROPHIC ULCERS

Shutov Yuri Mironovich, Veryatin Yakov Albertovich, Atamanov Konstantin Viktorovich, Lukanin Alexander Dmitrievich, Shumkov Oleg Anatolyevich

In Russia, over 35 million people suffer from various forms of varicose veins of the lower extremities, about 15% of them have trophic changes in the skin, half of which are accompanied by the formation of leg ulcers, and in 0.3% of cases they do not heal for a long time, recur many times and lead to to a significant deterioration in the quality of life of patients. In 12.5% of cases patients with venous trophic ulcers, due to decreased ability to work, are forced to prematurely stop working. These circumstances force us to identify the problem of treating venous ulcers not only as a medical one, but also as a socio-economic one. Treatment of this complication of chronic venous insufficiency is difficult, expensive and not always effective. In economically developed countries, huge amounts of money are spent on the treatment of such patients, amounting to 1.5 to 2% of the total health care budget. Despite significant advances in recent years in the diagnosis and treatment of chronic venous insufficiency, the incidence of venous ulcers remains at a high level and is not reliable. downward trend. Most phlebologists are unanimous in their opinion about the need for pathogenetically based treatment of venous trophic ulcers, aimed at eliminating the main cause of the development of chronic venous insufficiency - venous hypertension, which initiates changes at the tissue, cellular and microcirculatory level, ultimately leading to tissue destruction. Encouraging prospects have emerged with the introduction into clinical practice of fundamentally new high-tech methods of influencing reparative processes in patients with venous trophic ulcers. We have developed and put into practice a method for treating trophic ulcers of venous etiology with simultaneous effects on the lymphatic system of the region and cellular technologies using platelet-rich plasma. Positive macroscopic dynamics were accompanied by a decrease in the number of neutrophil leukocytes to 40-50%, with an increase in the number of polyblast histiocytes and endothelial cells. The overall effectiveness of the combined proposed method for 4 weeks of treatment was 70%, with treatment with traditional methods only 20%. The healing speed is 3.5 times more effective.

Keywords:trophic ulcer, chronic venous insufficiency, platelet-rich autoplasma, lymphostimulation