LONG-TERM CONSEQUENCES OF THE USE OF AUTOLOGOUS PLATELET-RICH PLASMA IN THE TREATMENT OF PATIENTS WITH DIABETIC ULCERS, AND MEDICAL AND SOCIAL ADAPTATION OF SUCH PATIENTS

Abstract

Relevance of the problem. According to the International Diabetes Federation (IDF), the number of patients with diabetes in the world reached 463 million people in 2019. One of the most severe local complications of diabetes is diabetic foot syndrome manifested through the development of diabetic ulcers on the lower extremities, which leads to poor quality of life and disability.

Objective. To evaluate the long-term outcomes after the use of autologous platelet-rich plasma in the treatment of patients with trophic ulcers secondary to type 2 diabetes mellitus and to study the peculiarities of medical and social adaptation of the patients who underwent such treatment vs. traditional methods.

Materials and methods. Study subjects were divided into two groups. The main group included 55 patients; the comparison group included 50 patients. Patients in the comparison group were treated according to the standard scheme in accordance with the recommendations of the International Working Group on the Diabetic Foot (IWGDF 2015). Treatment of patients in the main group was based on the above recommendations and corrected local treatment scheme according to our proposed method using autologous platelet-rich plasma. When studying the effectiveness of treatment, we used adapted EuroQol EQ-5D-5L questionnaire.

Statistical data were processed using the Student's t-test. The difference in average values at p<0.05 was taken as statistical significance.

Conclusions. It was found that the recurrence of ulceration in the main group of subjects occurred less frequently, as compared with patients in the comparison group (p<0.05).

Long-term follow-up period showed that 34 (72.3%) subjects in the main group had no mobility problems vs. 21 (46.7%) subjects in the comparison group. In the main group, 44 (95.7%) subjects did not require assistance in daily living activities vs. 35 (77.8%) subjects in the comparison group. In the main group, 33 (70.2%) subjects could participate in normal daily activities vs. 17 (37.8%) subjects in the comparison group.

37 (78.7%) patients in the main group were not prone to depression and in the comparison group, only 18 (40%) subjects were not depression-prone, which is 1.9 times less (p>0.05).