MORPHOLOLOGICAL FEATURES OF CHRONIC VENOUS ULCERS UNDER THE INFLUENCE OF DRUGS PLATELET RICH PLASMA

Reshetniak O. M., Olejnik A. E., Pasechnik A. V.

PATHOMORPHOLOGY

Scentific article

Was investigated the dinamics of therapeutic pathomorphosis of venous ulcers under influence of platelet rich plasma. Patients was divided on two groups. In the main group was included 8 patients that was treated with help of PRP by developed metodic. Comparing group was include 8 patients, that was threated by the standart methodic on a basic of phase of wound process. Biopsies was taken from different part of the wound surfase on 7 – th and 28 – th day of threatment. It was used modern immunogystochemical methodics that include using of monoclonal antibodies to markers of proliferative activity ki 67, collagens I, III and IV types fibroblasts growth factor, vessel endothelial growth factor(VEGF), endothelial cell factor (CD34), epidermal growth factor, macromolecular cytokeratin (Cytokeratin HMW), also was define receptors to macrophages (CD68). According to received data pathogenetically directed surgical treatment with combined use of the PRP accelerate the maturation of granulation tissue and accelerate re-epithelialization of the ulcer, which is already apparent on the 7-th day after initiation of treatment. In preparates of comparing group on 28-th day was found coarse-fibered connective tissue with deficient angiogenesis, which is represented by alternating areas of fibrosis with edema areas. All of it is covered with epithelium and presence of significant proliferative activity, acanthosis, subepidermal with signs of inflammatory reaction. This pattern determines the incompleteness of the tissue repair and insability of tissue parameters that in proper pathological conditions may be the cause for recurrence of ulcer. In the same period in the preparates of the main group it is possible to note the appearance of signs of physiological regeneration: adequate angiogenesis, fibrillogenesis with the correct orientation of collagen fibrils and complete re-epithelialization. From the above, we can say that our methodic create conditions for healing venous ulcers and reduce the possibility of relapse. Thus, based on these data, we can make the following conclusions: 1. Using of platelet rich plasma lead to decrease of swelling and inflammation in chronic venous ulcers and accelerated re-epithelialization, which is already apparent on the 7th day of treatment. 2. On the 28th day of treatment in the preparates of the main group was observed a significant increase in signs of reparative processes, in comparison with the comparison group, which is manifested in the absence of inflammation, swelling, deforming sclerosis that could destabilize the therapeutic effect and cause the recurrence of chronic ulcers. 3. Morphological manifestations of therapeutic pathomorphism in use of platelet rich plasma drugs associated with the provision of physiological tissue regeneration of chronic venous ulcers, which manifes by normalization of the ratio of fibrillar types of collagen, absance of foci of atypical collagen localization, adequate angiogenesis and re-epithelialization.

platelet rich plasma, venous ulcers, immunogystochemical methodics

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«Bulletin of problems biology and medicine» Issue 1 part 2 (127), 2016 year, 200-204 pages, index UDK 617.58: 616.14-002.44-036.12-08-091