Curación avanzada de úlceras crónicas refractarias mediante liberación transdérmica de factores de crecimiento y moléculas bioactivas.

Abstract

We propose an advanced cure protocol for ulcers by applying injectable platelet-rich fibrin, plasma gel, chitosan membrane and procaine for biostimulation of the tissue under the cellular repolarization scheme with transdermal release of growth factors and glycosaminoglycans, in a patient with ulcer refractory by iatrogenic injection in arm. The patient was referred from the general surgery service to the consultation requesting healing by second intention. The ulcer was previously treated with conventional healing techniques plus an intervention for autotransplant from the dermis to the ulcerated area, failed strategies for reepithelialization of the area. The control blood count showed normality and the bacteriological culture was negative. The diagnosis was chronic refractory ulcer of iatrogenic origin stage II due to inadequate injection of drug in the left upper extremity. The designed therapy consisted of wound cleaning, tissue debridement, wet healing, biostimulation of granulation tissue and subsequent re-epithelialization. In each session, once the ulcer was cleaned, the edges of the wound were infiltrated with 2% procaine for cellular repolarization, making it more receptive to treatment; Next, micro-injections of liquid fibrin rich in liquid platelets were made in the ulcer, the inner area was irrigated with platelet-rich fibrin and finally the entire area of the ulcer was covered with plasma gel loaded with antibiotic, seeking total coverage in the manner of dressing, covering the area with sterile gauze. The first cures were performed every 72 hours until week 3 and then weekly. The evolution of the ulcer was monitored for 14 weeks, during which the complete reepithelialization of the ulcer was observed.