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Kwas hialuronowy i aminokwasy wspomagają gojenie ran przewlekłych [CASE STUDY]

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Kluczowym etapem w procesie gojenia rany przewlekłej jest pobudzenie ziarninowania oraz naskórkowanie. Pomóc w tym mogą preparaty z zawartością kwasu hialuronowego oraz aminokwasów, czyli składników niezbędnych dla tworzenia włókien kolagenowych. O efektach terapii z zastosowaniem takich produktów mówi dla Forum Leczenia Ran dr n. med. Arkadiusz Krakowiecki z kliniki PODOS.

Leczenie ran trudno gojących się to skomplikowany, długotrwały proces. Można go wesprzeć poprzez stosowanie preparatów wspomagających regenerację tkanki, które pozwolą na szybsze zamknięcie rany.

Jednym z takich produktów jest Vulnamin, czyli preparat zawierający unikalną formułę HY4AA – połączenie hialuronianu sodu, jednego z głównych składników tkanki łącznej, oraz wybranych aminokwasów odpowiedzialnych za produkcję kolagenu. Dzięki połączeniu tych składników preparat wielokierunkowo wspomaga gojenie rany:

– redukuje odpowiedź zapalną,

– aktywuje namnażanie fibroblastów,

– pobudza produkcję nowych naczyń krwionośnych,

– stymuluje produkcję włókien kolagenowych i wspiera reepitelializację.

Preparat jest dostępny w czterech formach dostosowanych do potrzeb pacjenta: żel, krem, proszek (PWD) oraz spray. Jak mówi dr n. med. Arkadiusz Krakowiecki, Vulnamin może być stosowany na rany trudno gojące się o zróżnicowanej etiologii:

– W klinice PODOS wykonaliśmy ponad 600 aplikacji produktu Vulnamin u 74 pacjentów. Z uwagi na charakter działania preparatu stosowaliśmy go we wszystkich rodzajach ran przewlekłych, dołączając go do dotychczasowej terapii miejscowej, łącząc go zarówno z opatrunkami przeciwbakteryjnymi, jak i różnymi rodzajami opatrunków chłonnych. Najczęściej Vulnamin był wykorzystywany przez nas we wspomaganiu gojenia w zespole stopy cukrzycowej, rzadziej w niewydolności żylnej.

Jak podkreśla ekspert, stosowanie produktu Vulnamin dało zauważalne pozytywne efekty:

– Nasze wstępne doświadczenia z produktem Vulnamin są bardzo pozytywne. U większości naszych pacjentów wykorzystywany jest Vulnamin PWD, co wynika z tego, że leczone przez nas rany są rozległe i z dużym wysiękiem. Miejscowe stosowanie kwasu hialuronowego z aminokwasami zmniejsza stan zapalny w obrębie rany, przerywa katabolizm i zwiększa miejscowe ukrwienie, co znacząco przyspiesza ziarninowanie i naskórkowanie. Jednocześnie stosowanie kwasu hialuronowego w trakcie PSPG zwiększa szansę na pełne wgojenie przeszczepu. Wszystkie te czynniki istotnie skracają czas do pełnego zamknięcia rany.

Poniżej przedstawiamy przypadki z praktyki dr. Arkadiusza Krakowieckiego, w których wykorzystano preparat Vulnamin.

Przypadek nr 1

72-letnia kobieta z wieloletnim nikotynizmem, po licznych operacjach wewnątrznaczyniowych, z współistniejącym masywnym obrzękiem chłonnym i wyjściowym ABI 0,28. W trakcie zabiegu rewaskularyzacji udało się udrożnić jedynie t. udową powierzchowną, nie udało się sforsować niedrożności tętnic podudzia. Wskaźnik kostka-ramię po zabiegu wynosił 0,4. Wdrożone zostało leczenie zachowawcze, tj. drenaż limfatyczny, trening marszowy i z uwagi na obrzęk chłonny, pomimo niskiego ABI, kompresjoterapia pierwszego stopnia. Przy wdrożonym leczeniu rana zaczęła powoli się zamykać, ale u pacjentki doszło do zakażenia i gwałtownego powiększenia się rany. Kolejny zabieg rewaskularyzacji nie powiódł się, a pacjentka została zdyskwalifikowana do terapii hiperbarycznej. Wykonany ponownie ABI wynosił 0,33, a przezskórne ciśnienie parcjalne tlenu 28 mmHg. Rokowanie co do zagojenia rany w takiej sytuacji jest niekorzystne. W kolejnych tygodniach obserwowaliśmy powolne powiększanie się rany pomimo optymalnego leczenia miejscowego i systemowego. Po włączeniu do leczenia preparatu Vulnamin PWD rana zaczęła ziarninować i powoli naskórkować. Obecna wielkość rany stanowi około 10% największego wymiaru rany i stale się zmniejsza.

Przypadek nr 2

73-letnia kobieta z przewlekłą niewydolnością żylną, z okrężnym owrzodzeniem podudzia utrzymującym się od ponad 10 miesięcy. U pacjentki wdrożono kompresjoterapię, drenaż limfatyczny, na tydzień przed planowanym PSPG dołączono NPWT. W dniu zabiegu u  pacjentki obecny był nadal duży wysięk (około 100 ml/doba), co nie jest to optymalną sytuacją dla przeszczepu. Celem zwiększenia szansy na wgojenie się przeszczepu całość owrzodzenia pokryto produktem Vulnamin PWD, na który położono siatkowany przeszczep. Po miesiącu od zabiegu, a po niecałych 2 miesiącach do zgłoszenia się pacjentki do przychodni owrzodzenie całkowicie się zamknęło.

Przypadek nr 3

68-letni mężczyzna z cukrzycą typu 2, po skutecznej rewaskularyzacji. Pacjent zgłosił się do przychodni po amputacji palucha, z masywnym zakażeniem stopy. W przebiegu zakażenia doszło do martwicy ścięgien podeszwy stopy z wytworzeniem głęboko penetrującej do pięty kieszeni. Po rewaskularyzacji włączono NPWT, a po usunięciu zdewitalizowanych tkanek i opanowaniu zakażenia do kieszeni zaaplikowano przy pomocy łyżeczki kostnej Vulnamin. Pozwoliło to na zamknięcie 6 cm kieszeni w ciągu 11 dni i znacząco przyspieszyło termin wykonania PSPG.

Przypadek nr 4

65-letni mężczyzna z nierozpoznanym zespołem antyfosfolipidowym po kilkukrotnych zabiegach naczyniowych. Początkowo pacjent zakwalifikowany do amputacji na poziomie uda. W trakcie oczekiwania na rewaskularyzację doszło do progresji zmian martwiczych i pomimo skutecznego zabiegu zaszła konieczność amputacji stopy w stawie Choparta z pozostawieniem ukrwionego płata skóry z podeszwy stopy. Celem zmniejszenia ryzyka dalszej progresji martwicy u pacjenta włączono produkty Vulnamin PWD oraz Vulnamin krem razem z terapią NPWT. Ostatecznie po wgojeniu się płata skórnego ranę na przedniej części podudzia zamkniętą PSPG.

 

Dowiedz się więcej o produkcie Vulnamin:

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