Local personalised treatment of long-term non-healing wounds

Abstract

Introduction. A significant number of nosologies can result in long-term non-healing wounds that mostly have similar principles of local treatment. However, positive clinical outcomes are not always obtained in the management of such wounds. The authors have developed a personalized technology for local treatment of chronic wounds depending on their etiology. Aim. Was to investigate the effectiveness of the proposed methods and personalized approaches for local treatment of long-term nonhealing wounds. Materials and methods. Innovative methods of cleaning and stimulating regeneration of non-healing wounds have been developed in the study; their effectiveness was tested in 3 blocks of the study. The first block of the study included patients with long-term non-healing wounds of venous etiology, the second and third blocks included patients with long-term non-healing arterial and neurotrophic wounds, respectively. Each block involved two series of tests studying the developed methods of cryodestruction and stimulation of regeneration, respectively. In the 1st block, the 3rd series of tests was additionally conducted; it included patients with wounds larger than 20 cm2 in size. Results. The developed methods of cryodestruction accelerate the course of phase I of the wound process by 12% in patients with longterm non-healing wounds of venous etiology, by 27% in patients with critical ischemia of the lower extremities, by 70% in patients with neurotrophic etiology (p ≥ 0.05). The use of the proposed methods of stimulating regeneration significantly reduced the average area of wounds in the study blocks. The main components of treatment stimulating regeneration in long-term non-healing wounds have been identified considering wound etiology. Conclusion. The use of the developed algorithm for local personalized treatment of long-term non-healing wounds considering underlying disorders contributes to an earlier cleaning of the wound surface, elimination of inflammation and an increased activity of regeneration processes when compared with conventional approaches.