The aim: Was following: the improvement of the treatment results of the lower limbs ulcers, caused by the diabetes mellitus by using our technique of the platelet-rich plasma application; the study of the features of the morphological and immunohistochemical changes, and the effect of the growth factors of the platelet-rich plasma on the regeneration and healing of the ulcers. Materials and methods: 38 patients with the trophic ulcers of the lower limbs, caused by diabetes mellitus were involved in the study. To assess the morphological features of the reparative processes before and after the treatment with PRP, the histological and immunohystochemical studies of the biopsy specimen of ulcers were carried out. Results: The total epithelialization of the ulcers in the patients from the main group was achieved on 46.5 day, and in the comparison group – 81.7 day. The light and optical study of the specimen of the main group, using the autologous platelet-rich plasma revealed the elimination of the destructive changes and reduction of the mixed-cellular infiltration compared to the patients from the comparison group. The immunohystochemical study revealed the increase of the growth factors receptors. Conclusions: The usage of the autologous platelet-rich plasma in the treatment of the trophic ulcers results in the rapid regeneration by the decrease of the destructive and inflammatory changes as well as the improvement of the vascularization.

According to the WHO and the International Diabetes Federation (IDF), the number of patients with diabetes in the world reached 463 million people in 2019. A typical manifestation of complications of diabetes mellitus is the development of trophic ulcers of the lower extremities, which leads to poor quality of life, disability, and high financial costs for treatment.

Мета. Дослідити стан регенерації тканин у зоні трофічних виразок венозного ґенезу. Матеріали і методи. Протягом 2017 р. на базі хірургічного відділення Сумського обласного клінічного госпіталю ветеранів війни проведено лікування 57 хворих з трофічними виразками нижніх кінцівок шляхом застосування аутоплазми, збагаченої тромбоцитами (АПЗТ). Результати. На 20-ту добу від початку лікування у хворих основної групи площа виразкового дефекту зменшувалась на 45,8% у порівнянні з вихідними даними, у хворих контрольної групи - лише на 31,4%, що в 1,4 разу менше (p < 0,05). Висновки. Покращення регенерації тканин у зоні виразки за рахунок епідермізації скорочує строки її епітелізації у разі застосування АПЗТ у 2,3 разу.

The aim — to assess life quality of patients with trophic ulcers of venous genesisMaterials and methods. A survey of 85 patients who are on inpatient treatment for venous trophic ulcers was conducted. According to the CEAP classification all patients had chronic venous insufficiency of the C4—C6 stages. The mean age of the patients was 74 years. The duration of the ulcer was at least 1 year. To assess the patients’ life quality with varicose veins, the CIVIQ scale was chosen. The total score was from 20 to 100, and the higher the value the worse the life quality.Results and discussion. After the questioning, the scoring was carried out. When comparing two groups of patients, it was found that the living standard in the main group was 45.7 in the standard group, and 23 in the control group. Thus, the presence of chronic venous insufficiency, and, as a consequence, of trophic ulcers, worsens the life quality almost 2­fold.Conclusions. Complicated forms of varicose veins significantly impair the patients’ life quality, and cause both physical and moral discomfort for a long time.