Assessment of proliferative potential using the local influence of cell technologies and negative pressure therapy in the complex treatment of trophic defects in patients with chronic disease of the veins of the lower extremities C6

November 21, 2023
УДК:  616.147.3-007.64-002.44-7-089.819:576.7:57.086.83:615.47:621.3.032.11
Specialities :

The aim: to determine the difference in the expression of the marker of proliferative potential Ki-67 in the treatment of patients with C6 chronic disease of the veins with the use of PRP and NPWT in comparison with traditional methods of wound care and elimination of vertical reflux.

Materials and methods. The study included 75 patients with C6 chronic disease of the veins. The main group: 34 patients, 16 (47.1%) men and 18 (52.9%) women who underwent preoperative preparation with mechanical and enzymatic debridement, the use of modern super absorbent hydroactive wound dressings, PRP and NPWT, and minimally invasive surgery. Comparison group: 41 patients, 14 (34.2%) men and 27 (65.8%) women who underwent standard surgical intervention with crossectomy and stripping, miniphlebectomy or scleroobliteration in combination with local treatment.

Results. The use of the proposed tactics of preoperative preparation makes it possible to reduce the duration of the preparation of the wound bed for surgical intervention from 15.39 to 6.03 days. Immunohistochemically, the significant effectiveness of the use of PRP in the treatment of trophic ulcers on the background of chronic disease of the veins was confirmed, which is manifested in a significantly higher expression of the Ki-67 antibody, whereas the main group, on average, there were 19 to 24 mitotically active cells per field of view, in the comparison group, from 8 to 16.

Conclusions. Due to the creation of negative pressure, through physical contraction — dermotension, it leads to the removal of toxins and excessive interstitial fluid from the wound, improvement of trophic and neoangiogenesis. The proposed tactic of preoperative preparation and treatment of patients with C6 chronic disease of the veins allows reducing the time of preparing the wound bed and the patient for surgical intervention by 2.55 times. The use of PRP and NPWT has several advantages and biological effects that lead to the reduction of inflammation, cleansing of the trophic ulcer, reduction of edema, elimination of the biological film, stimulation of neoangiogenesis and, as a result, healing of the trophic ulcer.


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