APPLICATION OF PRP AND PRF TECHNOLOGIES IN PREPARATION FOR THE IMPLEMENTATION OF RADIOFREQUENCY VEIN ABLATION IN PATIENTS WITH VARICOSITY OF THE LOWER EXTREMITIES, TROPHIC ULCER COMPLICATIONS
DOI:
https://doi.org/10.11603/1811-2471.2019.v0.i2.10376Keywords:
varicose veins, trophic ulcers, PRP and PRF technologyAbstract
The use of minimally invasive technology is a modern trend in the treatment of varicose disease of the lower extremities. However, there are certain restrictions for performing these operations against trophic ulcers.
The aim of the study – to provide a clinical rationale for the use of PRP and PRF technology for the treatment of trophic ulcers in patients with chronic venous insufficiency in the decompensation stage, with the aim of performing radiofrequency ablation of the veins.
Material and Methods. Clinical studies of the use of PRP and PRF technologies for the treatment of trophic ulcers in 35 patients, the control group were 30 patients in whom trophic ulcers were treated with methyluracil or actovegin ointment. All patients underwent an ultrasound study of hemodynamics in superficial and deep veins, revealed the presence of vertical and horizontal reflux. Also, all patients were assessed for the status of trophic ulcers before and during treatment using the MEASURE system.
Results and Discussion. The use of PRP and PRF technology significantly enhances the processes of regeneration in a trophic ulcer, as evidenced by the reduction in the term of the appearance of granulation tissue, marginal epithelization, as compared with the control group of patients. There was a decrease in the area and depth of the wound defect by 23.1 %, 37.4 % and 79.9 % by 5–6, 8–9, 12–14 days compared with baseline data. Up to 8 days, most patients showed a change in the nature of the cytogram to the regenerative-inflammatory type. Dendrite and microbial bodies disappear. A characteristic sign in patients of the main group of patients is swallowed epithelization. In 24 (68.6 %) patients, the trophic ulcer healed. The remaining 11 patients underwent trophic ulcer autodermoplasty during radiofrequency ablation of the veins. It should be noted that on average, the day of preoperative preparation of patients with trophic ulcers, in which PRP and PRF were applied and the technology was (7.8±4.6) days, against (14.6±3.7) days in the control group of patients. This made it possible to conduct a full-fledged RFA of varicose transforming veins with additional elimination of horizontal reflux in the area of trophic changes due to the use of sclerotherapy of insignificant perforant hives under ultrasound navigation.
Conclusions. 1. The use of PRP and PRF technology activates the processes of regeneration in chronic trophic ulcer, allowing to reduce the preoperative preparation of patients.
2. PRP and PRF technologists in the treatment of trophic ulcers in combination with low-impact operations (RFA and sclerotherapy) is a promising direction in the treatment of patients with lower limb varicose veins in the decompensation stage.
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