Alternative method of treating prolonged wound defects of trunk and extremities

Abstract

The aim of the study is to improve the treatment results in patients with prolonged wound defects on the trunk and extremities by using alternative methods. Materials and methods of research: 75 patients with neurotrophic disorders aged 19–76 years were treated. Of the total number 25 (33.3 %) of patients were treated according to the methodology having been developed in the clinic. Results and discussion: In 25 (33.3 %) cases of a neurotrophic ulcerative defect, skin regeneration course was prescribed for 2 to 6 weeks. We have had positive results (complete defects healing) in all the cases. The clinical experience of using hyaluronic acid preparation has been scientifically substantiated by the complex pathomorphological studies of skin biopsy material (histological, histochemical, immunohistochemical techniques ones using monoclonal antibodies Rb a-Hu Collagen I, Clone RAHC11 and Rb a-Hu Collagen III, Clone RAHC33 (Imtek, Russian Federation) to collagen I and III types). Conclusions: The choice of corrective intervention method and the closure of the defect depended on the size, depth of the wound and the functional characteristics of the site of the injury. The new method of treatment of neurotrophic ulcers expands the prospects for treatment of patients with defects in the integumentary tissues. At the pathomorphological examination, the signs of healing with hyperproliferative processes were revealed in the epidermis, hyperkeratosis, parakeratosis, and excessive accumulation of collagen type I that characterized pathological healing and was often determined in the epidermis in chronic ulcers. Differential approach to selecting the method of closing wound surfaces makes it possible to achieve positive results in 98.1 % of cases.

Keywords

• wounds
• ulcer
• morphological and microscopic findings
• hyaluronic acid