Rehabilitation in patients with involutional-dystrophic skin changes

Abstract

The study was aimed to assess the effectiveness of rehabilitation in patients with involutional-dystrophic skin changes

Material and methods. The study was performed in the clinical department of the Ukrainian Research Institute of Medical Rehabilitation and Balneology of the Ministry of Health of Ukraine, as well as the Odessa Regional Clinical Medical Center of the Ministry of Health of Ukraine and the Kherson Regional Clinical Hospital in 2016-2020.

287 women of middle age (average age 46.47 ± 1.97 year) with signs of functional changes in the skin were involved in the study. All patients required rehabilitation of impaired skin function (code b810 by ICF, LA22123-6 by LOINC).

General sample (n=287) was randomly divided into two groups. Patients in the control group (n = 187) received cosmetic measures in the form of ultrasonic peeling, cleansing, nourishing facial masks. Patients of the main group (n = 100) were injected intradermally and subcutaneously with platelet-enriched autoplasma up to 5 ml, which was obtained by double centrifugation.

Ultrasound scanning of the skin and laser Doppler flowmetry (LDF) were used to assess the structural features of the epidermis, dermis and subcutaneous fat. Dynamic control of skin structures included the study of the initial state of the skin at certain points of the face (center of the cheek, center of the forehead, outer corner of the eye), which we set as standard. Assessment of the effectiveness of the rehabilitation was performed before first procedure and in 3 and 6 months after it completion. Statistical processing was performed using software Statistica 13.0 (TIBCO, USA)

Results. After 3 months of follow-up after PRP-therapy revealed even greater significant differences in the structural and functional parameters of the skin compared to baseline. There was an increase in the thickness of the epidermis by 16.7%, the level of hydration increased by 26.9%, the level of TEV by 29.5%, the oiliness of the skin or the level of seboregulation increased by 16.8% (p ≤ 0.05). Important characteristics of the protective effect of PRP therapy were an increase in the elastic properties of the skin by 31.8% and an increase in the microcirculatory network by 23.1% compared to baseline before the procedure of PRP therapy (p ≤ 0.05).

Conclusion. The proposed method can be used as a stand-alone complex conservative therapeutic method of treatment and is used after surgery to rejuvenate the skin of the face and neck in people over 40 years. It has been shown that the effectiveness of restoring the functional state of the musculoskeletal corset of the face increases when using PRP at the same time as massage. It is substantiated that the combination of activation massage and regenerative stimulation by the introduction of PRP should be carried out simultaneously during treatment throughout the course.