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在局麻手术中,采用射频消融联合超声辅助清创术以及富血小板血浆和富血小板纤维蛋白技术治疗下肢静脉性溃疡。

Radiofrequency ablation of varicose veins in combination with ultrasonic-assisted wound debridement and platelet-rich plasma as well as platelet-rich fibrin technologies in treatment of lower extremity venous ulcers in office-based surgery.

机构信息

Department of Surgery, Institute of Postgraduate Education, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.

Department of Internal Medicine N 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.

出版信息

Pan Afr Med J. 2022 Jun 24;42:154. doi: 10.11604/pamj.2022.42.154.29834. eCollection 2022.


DOI:10.11604/pamj.2022.42.154.29834
PMID:36187047
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9482222/
Abstract

INTRODUCTION: for the treatment of varicose ulcer performed clinical and laboratory reasoning of the use of ultrasonic-assisted venous ulcer debridement and Platelet-rich plasma with radiofrequency ablation in an outpatient setting, was carried out. METHODS: ultrasonic-assisted debridement of trophic ulcer were performed for 50 patients with lower extremity varicose veins at decompensation stage. The effectiveness of ultrasonic-assisted debridement was evaluated by indicators of bacteriological, morphological, cytological study and assessment of trophic ulcers according to the MEASURE system. After ultrasonic-assisted debridement, the patients were divided into two groups: 30 patients, who underwent combined Platelet-rich plasma to stimulate wound regeneration and 20 patients, for whom the Granuflex hydrocolloid bandage was applied for the same purpose. RESULTS: a comparative analysis of ulcer regeneration in two groups of patients proved that in cases of platelet rich plasma the time of transition from inflammatory-regenerative type to regenerative one is much shorter than when using a hydrocolloid dressing. In 28 patients undergoing Platelet-rich plasma (PRP) and Platelet-rich fibrin (PRF), the radiofrequency ablation of the principal superficial and perforating veins was performed. Another 22 patients performed autodermoplasty of trophic ulcers after radiofrequency ablation. CONCLUSION: our experience has shown that in a one-day inpatient surgical clinic such a multidisciplinary approach to treatment of venous ulcers, including ultrasonic-assisted debridement that is stimulation of wounded process by Platelet-rich plasma with further surgeries to remove the causes of decompensated chronic insufficiency, is promising regarding low costs of treatment and rehabilitation of these patients.

摘要

简介:为了治疗静脉曲张性溃疡,我们在门诊环境下进行了临床和实验室推理,使用超声辅助静脉溃疡清创术和富含血小板的血浆联合射频消融术。

方法:对 50 例下肢静脉曲张失代偿期患者进行超声辅助清创术。采用细菌学、形态学、细胞学研究指标及根据 MEASURE 系统评估营养性溃疡,评价超声辅助清创术的疗效。超声辅助清创术后,将患者分为两组:30 例患者接受富含血小板的血浆联合治疗以刺激伤口再生,20 例患者接受 Granuflex 水胶体绷带治疗。

结果:对两组患者溃疡再生的比较分析证明,在富含血小板的情况下,从炎症再生型向再生型转变的时间比使用水胶体敷料要短得多。28 例接受富含血小板的血浆(PRP)和富含血小板纤维蛋白(PRF)治疗的患者进行了主要浅静脉和穿通静脉的射频消融术。另外 22 例患者在射频消融术后进行了营养性溃疡的自体皮移植术。

结论:我们的经验表明,在一天的住院手术诊所中,采用多学科方法治疗静脉溃疡,包括超声辅助清创术刺激富含血小板的血浆的伤口愈合过程,进一步进行手术以消除失代偿性慢性功能不全的原因,对于这些患者的治疗和康复具有成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c74/9482222/8189039cb885/PAMJ-42-154-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c74/9482222/1c38581b58cb/PAMJ-42-154-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c74/9482222/a58dc3684232/PAMJ-42-154-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c74/9482222/8189039cb885/PAMJ-42-154-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c74/9482222/1c38581b58cb/PAMJ-42-154-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c74/9482222/a58dc3684232/PAMJ-42-154-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c74/9482222/8189039cb885/PAMJ-42-154-g003.jpg

相似文献

[1]
Radiofrequency ablation of varicose veins in combination with ultrasonic-assisted wound debridement and platelet-rich plasma as well as platelet-rich fibrin technologies in treatment of lower extremity venous ulcers in office-based surgery.

Pan Afr Med J. 2022

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
[The application of combined low-intensity laser therapy for the treatment of the patients presenting with trophic ulcers associated with chronic venous insufficiency of the lower extremities].

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引用本文的文献

[1]
Clinical efficacy and safety analysis of ultrasound-guided radiofrequency ablation for varicose veins of lower extremities.

Am J Transl Res. 2025-5-15

本文引用的文献

[1]
Perspectives on Using Platelet-Rich Plasma and Platelet-Rich Fibrin for Managing Patients with Critical Lower Limb Ischemia After Partial Foot Amputation.

J Med Life. 2020

[2]
Venous Ulcers: Diagnosis and Treatment.

Am Fam Physician. 2019-9-1

[3]
Active debridement of venous leg ulcers: a literature review to inform clinical practice.

Br J Community Nurs. 2019-6-1

[4]
Autologous Platelet-Rich Plasma for Nonhealing Ulcers: A Comparative Study.

Vasc Specialist Int. 2019-3

[5]
Survey of patients of the Tver region of Russia regarding maggots and maggot therapy.

Int Wound J. 2018-12-13

[6]
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Int J Med Sci. 2018-8-6

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N Engl J Med. 2018-4-24

[8]
Wound-bed preparation: a vital step in the healing process.

Br J Nurs. 2017-6-22

[9]
The Effectiveness of Debridement for Venous Leg Ulcers.

Am J Nurs. 2016-9

[10]
Wound bed preparation: TIME for an update.

Int Wound J. 2016-9

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