Применение ацеллюлярных дермальных матриксов в лечении трофических язв нижних конечностей

Introduction. The paper describes the experience with acellular dermal matrices (ADM) used in patients with trophic ulcers (TU) and their comparative analysis with traditional autodermoplasty (ADP) on granulation. Subjects and methods. The early (10–14-day) and late (over a year) results were analyzed in 8 TU patients aged 25–55 years who used ADM – Integra Dermal Regeneration Template (IDRT) (INTEGRA Life Sciences Corporation, USA). All the patients with TU met the following criteria: an area of 25 to 150 cm2; a proliferative phase of the wound process; a defect duration of more than 12 months (during medical treatment). The patients were divided into 2 groups: 1) 5 female patients used IDRT (a two-layer variant); 2) 3 patients (2 women and 1 man) had IDRTSL (a one-layer variant). A comparison group consisted of 5 patients (3 women and 2 men) who underwent ADP on granulation without ADM. The patients were assessed by age, sex, TU site, extent, and etiology, disease duration, previous treatment, and the presence of comorbidities. Results. On days 10–14, the mean autodermal graft retention rate in Groups 1 and 2 was 72.0 and 66.7 %, respectively, whereas that in the comparison group was 75 %. The shortest length of hospital stay was observed in the comparison group. However, within a year, 4 (80 %) of the 5 patients in this group were unsatisfied with the results of treatment, which was associated with recurrent TU or the development of hypertrophic ulcer. No recurrences were noted in the study groups (Groups 1 and 2). All the 8 (100 %) patients confirmed that the proposed treatment option met their expectations and reported their better quality of life.