NEW TECHNOLOGIES IN THE TREATMENT OF PATIENTS WITH VARICOSE DISEASE AT THE STAGE OF TROPHIC DISORDERS

Trophic ulcers of the leg are the most common complication of chronic venous insufficiency of the lower extremities. It is currently believed that venous trophic ulcers occur in 2% to 4-5% of the adult population of industrialized countries. After 65 years, the frequency of venous trophic ulcers increases 3 or more times, reaching 3-6%. According to the European Community, in the next 10 years the number of patients with venous ulcers will increase by 20%. In the general structure of skin trophic disorders, ulcers of venous etiology account for 70-75%. Despite significant progress in diagnosis and treatment, only 50% of venous trophic ulcers with complex treatment heal within the next 4 months, 20% of patients remain non-healing within 2 years, and in 8% ulcers do not heal within 5 -summer observation. Even in the case of complete closure of the ulcer, the relapse rate remains at 6-15%. It follows from this that the treatment of trophic ulcers is a difficult and not always solvable process. Data obtained in recent years on the biological processes occurring in chronic wounds at the cellular and molecular level have made it possible to expand the understanding of the pathogenesis of trophic ulcers and propose new approaches to the treatment of venous trophic ulcers. In our opinion, the most justified and promising in the treatment of long-term non-healing ulcers is the use of regenerative medicine methods, including those based on the use of platelet-enriched autoplasma containing growth factors in natural biological concentrations, especially those that manifest themselves in conditions of restoring the drainage and detoxification function of a given anatomical region. We have developed and put into practice a method for treating venous trophic ulcers through injection subulcerous use of platelet-enriched autoflame in combination with regional lymphostimulation (Patent No. 2639123 dated 12/19/2017). As the results of the study showed, using this method of treatment in 4 weeks, complete epithelization of the venous trophic ulcer was achieved in 70% of patients, i.e. accelerate the process of epithelization of venous trophic ulcers by 3.5 times compared to the second comparison group.

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