APPLICATION OF AUTOPLATELET GROWTH FACTORS IN COMBINATION WITH LYMPHOCORRECTION IN PATIENTS WITH LONG-TERM NON-HEALING VENOUS TROPHIC ULCERS

Shutov Yuri Mironovich, Shumkov Oleg Anatolyevich, Veryatin Yakov Albertovich

The main cause in the pathogenesis of trophic manifestations on the shin in varicose veins is chronic lymphovenous insufficiency, manifested by tissue edema. Stagnant phenomena contribute to a decrease in blood flow, ischemia and tissue necrosis. An increase in pressure in the veins by more than 30 mmHg leads to the opening of arteriovenous anastomoses, a sharp decrease in blood flow in the capillaries occurs. Retrograde blood flow through the perforant veins of the lower leg increases tissue hypoxia and the progression of destructive processes due to leukocyte aggression. We have developed a method for the treatment of trophic venous ulcers by subulcerous application of platelet-rich autoplasm in combination with regional lymphotropic therapy. Correction and restoration of regional lymph outflow, leads to a decrease in pressure in the venous system, restoration of blood flow at the microcirculatory level. The elimination of malleolar edema of the lower leg with the subulcerous use of platelet-enriched autoplasm promotes rapid healing of an open trophic ulcer of venous etiology. The enhancement of reparative processes is associated with the influence of highly active platelet biocomponents that positively affect tissue regeneration in an open trophic ulcer. Treatment of patients with venous trophic ulcers according to the method developed by us, in any phase of the inflammatory process, promotes rapid purification and complete healing of trophic venous ulcers in a short time, while significantly reducing the likelihood of recurrence of the ulcer. The method does not require additional equipment, is low-cost and can be used in all medical institutions of a surgical profile. The results of treatment of patients with venous trophic ulcers were analyzed for 90 patients. 3 groups of 30 patients each. The first group of 30 patients was a control group treated according to a generally accepted method and in 2 comparison groups of 30 patients in whom subulcerose injections of platelet-enriched autoplasm were used. In the first group with lymphostimulation, in the second group without lymphostimulation.

Keywords:platelet-enriched autoplasma, varicose veins, chronic venous insufficiency, lymphostimulation