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