Prospective randomized clinical trials of efficiency of autologous platelet-derived concentrates to stimulate regeneration of trophic ulcers of venous etiology

Abstract

Objectives: To analyze the clinical and social efficiency of the designed method of autologous platelet concentrates (APC) application in the complex treatment of patients with small-sized trophic venous ulcers. Methods: Short- and long-term treatment results of 58 patients with chronic trophic ulcers of venous etiology have been evaluated. After pathogenetic surgical correction aimed to eliminate the causes of ulcers patients were divided into 2 groups depending on the method of treatment. In the main group to stimulate additionally the repairing of trophic ulcer a combined method of APC use (platelet-rich fibrin matrix (OTFM) and platelet-rich plasma (PRP) have been used. The main complex treatment has been performed in the comparison group. The clinical effectiveness of different treatment option was evaluated by means of the dynamics of changes of the ulcer area, epithelization rate, time of complete ulcer epithelization, duration of hospitalization. Social effect was estimated based on the analysis of life quality according to CIVIQ questionnaire. Results: The additional use of APC in the complex treatment of patients with trophic venous ulcers was found out to lead to the increased rate of epithelization up to 0,09 (0,04; 0,2) cm2 per day, significant reduction of ulcerous defect in dynamics (p<0,05), decline of complete ulcer healing occurrence (p<0,05) on the 10th day, increase of life quality according to questionnaire CIVIQ on 12,5 points (p<0,05). Conclusions: The developed method of treating patients with trophic venous ulcers based on a stimulating effect of autologous platelet concentrates is considered to improve the efficiency of complex treatment and achieve a significant social effect in the postoperative period.