КЛИНИЧЕСКАЯ ЭФФЕКТИВНОСТЬ PRP-ТЕРАПИИ И ДИНАМИКА ФАКТОРОВ РОСТА У ПАЦИЕНТОВ С ДЛИТЕЛЬНО НЕЗАЖИВАЮЩИМИ РАНАМИ

Abstract

Objective: To evaluate the clinical efficacy of platelet-rich plasma (PRP) therapy and its effects on serum concentrations of vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and transforming growth factor beta (TGF-β) in patients with chronic non-healing wounds of various etiologies. Methods: This prospective randomized study included 60 patients with chronic non-healing wounds of various etiologies. The main group (MG) comprised 30 patients who received PRP therapy, while the control group (CG) included 30 patients who received standard treatment. Treatment efficacy was assessed based on changes in wound area, the rate of epithelialization, and serum concentrations of the growth factors VEGF, PDGF, and TGF-β. Biomarker concentrations were measured at admission and on day 14 using enzyme-linked immunosorbent assay (ELISA). Results: In the MG, wound area decreased significantly by day 7 and further decreased by day 14 (p<0.001). The CG also showed a tendency toward reduced wound area (p=0.045); however, after Bonferroni correction (p<0.017), this decrease was not statistically significant. At the between-group comparison on day 14, wound area was significantly smaller in the TG than in the CG (p=0.008). In the TG, PRP therapy was associated with statistically significant increases in VEGF (p<0.001), PDGF (p=0.004), and TGF-β (p=0.039) levels by day 14 compared with baseline values. The CG showed no statistically significant changes (p>0.05). At the between-group comparison on day 14, serum concentrations of VEGF, PDGF, and TGF-β were significantly higher in the TG than in the CG (p<0.001, p=0.002, and p=0.037, respectively). Conclusion: PRP therapy significantly improves clinical and molecular indicators of tissue regeneration and accelerates the healing of chronic non-healing wounds. These findings support the potential for broader use of PRP therapy in the clinical management of patients with chronic non-healing wounds. Keywords: Chronic non-healing wounds, platelet-rich plasma, growth factors, tissue regeneration, molecular mechanisms.