DYNAMICS OF THE CYTOLOGICAL PICTURE OF THE RAS PROCESS IN PATIENTS WITH CHRONIC RANES IN APPLICATION OF PRP-THERAPY

Abstract

Wound healing is one of the most ancient surgical problems that has not lost its relevance. In the treatment of wounds, surgeons often deal with defects in the covering tissues, which are characterized by signs of chronic inflammation, high bacterial contamination. The aim of the work was to improve the regenerative processes of chronic wounds, using a combination of therapeutic PRP-therapy. Materials and methods. In the period from 2011 to 2017, on the basis of a surgical department, a comprehensive examination and treatment with the proposed and substantiated method was performed for 99 patients with HW, which, in addition to the comprehensive treatment of HW, received local platelet-rich platelet therapy (PRP). The comparison group (Group II) was 101 patients with HW who were treated according to traditional approaches. Patients in the main group used PRP in the form of daily subcutaneous and intradermal injections and applications. The generated plasma was recruited into two insulin syringes of 1 ml each and injected along the periphery of the wound (approximately 20 injections of 0.1 ml). The cytological picture of the wound process was determined with the allocation of 6 types of cytological picture of smears-reflections for Steinberg. The study was performed 4 and 10 days after the start of treatment. Results and discussion. The analysis showed that at day 4, type IV of the cytogram predominated in patients of the (main) group of patients, and therefore the relative "readiness" to further plastic closure of the wound defect was found in only 3 (3,03%) patients. In the second group, 1 (0.99%) patient. On the 10th day of the wound process there is a statistically significant displacement of the cytological picture in the subgroups receiving PRP-therapy in the direction of regenerator types IV, V, VI type of cytogram, and hence relative "readiness" to further plastic closure of the wound defect. Conclusions The use of PRP therapy in the complex of treatment of chronic wounds is clinically effective, which is confirmed by the data of dynamic cytological research, the method allows to accelerate the processes of wound repair.