Zhadko S. I., Bezrukova O.S.

State institution “Crimea state medical university named after S. I. Georgievsky” Simferopol, Ukraine

Results of clinical estimation of elimination of the face soft tissues deformation using injection of PRP-gel

Today the injection method of defects and deformations of the face soft tissues elimination is one of the most developing and perspective direction in plastic and reconstructive maxillofacial surgery. This contributes minor trauma, high efficiency and availability of method. But the positive results of treatment not always stable. And thre are many complications (40% of cases). It's due to tendency of implants and transplants to migration from the area of placement , with development of secondary deformation and local inflammatory reactions. The most possible cause of unsatisfactory results is technological defects in transplant preparation and placement methods.

The object of study was to increase the efficiency of treatment of the patients with defects and deformation of face soft tissue by development and implementation the method of platelet-rich plasma of the autologous blood injection.

Material and methods. Were formated 3 clinical group of comparison, 133 patients, which collated by number (1^st main – 46 patients, 2^nd main – 57 people , the control – 30), and also by basic criteria : the character and localization of inflammation, sex and age)

All female patients carried out the course of treatment and examination in in ambulatory regimen. The basic conservative complex was not significantly different in comparison groups.

The groups of observation consist of the patients with posttraumatic

version of defects and deformation of the face soft tissues:hypertrophic scars

(as example of deformation), atrophic scars , functional and neurogenic hypotrophy (as a defect).

In control group used the method of lipofiling. The transplant subfascially single layer injected , using from 2 till 10 ml of material. Considering the propensity of transplanted adipose tissue to partial resorption, the material injected with hypercorrection .

The elimination of defects in patients of the main group carried out by our developed method – stratified placement of PRP-gel in tissues. In first group for defects and deformation elimination used platelet rich plasma, contained heparin.

In second main group injected in soft tissues PRP-gel, obtained from the clotted platelet rich plasma. For the volume and form of tissue correction infiltrated 3 layers: muscular, subcutaneous and submucous.

The regestration of clinical symptoms changes in early posttransplantation period conducted everyday for a week, and then on 14-15^th day, that allows to give a comparative evaluation of local inflammatory reactions severity and to follow the dynamics of it extinction in observation groups.

The results of the study. By all analyzed clinical scores( hyperemia, local edema, the pain) in both groups identified significant differences, which point out , that the less pronounced and shorter inflammatory reactions in implantation zone were in 2 group and specially in first main group. By the frequency of occurrence of symptoms were intergroup differences in all terms of early posttransplantation period.

The comparative analysis of data, received during clinical examinations and observations of patients in early (first 14 days) and in long-term period

(6 and 12 month) also allowed to identify significant differences by most measures: the number of cases of complete deformations elimination, uneven material distribution with areas of lumpiness appearance, the partial migration of transplant from the injection zone.The positive dynamics was more expressed in 2^nd and 1^st main groups.

It necessary to note, that the largest number of “lumpiness” were identified in patients of control group. It presence in tissues leaded to aesthetic and functional disturbances.

The index , reflecting the number of additional injections of adipose transplant and PRP-gel, performed to remove residual deformations, testified about the partial resorption of transplant in tissues after injection .It was significantly more high in control group.

The local inflammatory processes , associated with placement of transplant in tissues (if not completed the process of it integration) noticed in long-term of observation in 13,64% of patients of control group (2,44% - in 2^nd main). It developed in kinetic zone.

The number of positive outcome of treatment was more high in 2^nd main group (92,68 %, against 68,18 % - in control). The bal estimation of final results of contouring showed the most high level (3,9 bal ) in 2^nd main group.

3,86 bal recorded in 1^st main and 3,54 – in control.

The conclusion. The analysis of character of clinical data changes in groups in early posttransplantation period point out to efficiency of placement of PRP-gel in the tissue layer by layer in defect and deformation area. In background of using this gel the inflammatory processes passes less pronounced. It attenuation comes on 6 th day , and during using the small diameter of the needle – om 5^th day(in control - 14-15 day)