[Effectiveness of local treatment of venous trophic ulcers in gerontological patients].

Abstract

Objective: To assess the effectiveness of local treatment of venous trophic ulcers in gerontological patients.

Material and methods: We analyzed treatment venous trophic ulcers in 4 groups of elderly and senile patients. All patients received conservative therapy. In the 1^st group (n-74), local injection of 0.1% polyhexanide-betaine gel throughout 7-10 days was followed by liposomal antioxidant-phospholipid complex «Flamena». In the 2^nd group (n-69), immune correction with «Imunofan» was carried out along with local therapy. In the 3^rd group (n-69), local treatment was combined with pulsed high-intensity optical irradiation of the wound. In the 4^th group (n-69), local treatment was combined with immune correction and pulsed high-intensity optical irradiation. Cytological analysis was performed to estimate effectiveness of treatment. Statistical analysis was performed using nonparametric Friedman and Mann-Whitney tests.

Results: The number of leukocytes, lymphocytes and macrophages increased by the 7^th day of treatment. Activation of inflammation was more pronounced in groups 2, 3 and 4 (p< 0.0083). By the 15^th day, leukocyte count decreased. The number of macrophages and lymphocytes remains high; the number of fibroblasts increases. Cytograms were mainly inflammatory and inflammatory-regenerative. By the 22^nd day, cytograms corresponded to regenerative-inflammatory and regenerative types with the lowest number of neutrophils, moderate number of lymphocytes, macrophages and fibroblasts.

Conclusion: Complex local treatment of venous trophic ulcers with local immunomodulatory therapy and pulsed high-intensity optical irradiation contributes to conversion of chronic inflammation to acute one with initiation of reparation processes and tissue regeneration.