REMOTE RESULTS OF USING PROSTAGLANDINS E1 AND IMMUNOTHERAPY IN COMBINED MODALITY TREATMENT OF VARIOUS-AETIOLOGY TROPHIC ULCERS

Alekhin D.I., Mikhailova O.A., Sumnaya D.В., Dodonov N.P., Baltrushevich O.A.
Uralian State Academy of Advanced Medical Education,
Chelyabinsk, Russia

The purpose of this study was to assess short- and long-term efficacy of combined-modality therapy (comprising PGE1-group preparations and immunocorrection) used to treat indolent trophic ulcers in patients presenting with chronic venous insufficiency (CVI) and cutaneous angiitis.

Examined herein were both immediate and remote therapeutic outcomes obtained in patients suffering from indolent trophic ulcers secondary to CVI (post-thrombophlebic disease [PTPD] and varicose disease [VD]), as well as ulcers resulting from vasculitis or vasculopathy. The conventional therapy was supplemented with infusion of PGE1-group preparations and immunocorrection.

Also investigated were the indices of microcirculation and the immune status, the percentage of the trophic ulcers having healed, the trophic-ulcer recurrence rate in the remote period, feasibility of further performing a radical surgical intervention, the patients’ quality of life after the treatment, and the need for repeat therapeutic courses according to the regimen proposed.

The use of PGE1-group preparations in a combination with immunocorrection confirmed high efficacy of the treatment for various-aetiology trophic ulcers (with the preserved arterial blood flow). The trophic ulcers were observed to epithelialize rapidly following the initiation of treatment, thus making it possible to appropriately prepare the patient suffering from varicose disease for further surgical management. The remote-period evidence clearly showed that the use of the proposed therapeutic regimen had eventually led to a considerable improvement in the patients’ quality of life, dramatically decreasing the recurrence rate of trophic ulcers in patients with PTPD and vasculopathies, and thus may safely be recommended both for prevention of ulcer relapses and as part of maintaining therapeutic courses. The detected deviations in the immune status of the patients afflicted with vasculitis and those suffering from CVI confirmed the need for immunocorrection.

KEY WORDS: trophic ulcers, venous insufficiency, cutaneous angiitis, vasculopathies, prostaglandins E1.

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