Treatment of chronic skin ulcers

Skin ulcersrepresent a growing pathology in general medicine, dermatology and vascular surgery practices due to the progressive aging of the population. The patient must make a large number of trips and consultations, sometimes for years, until this pathology is resolved. This, added to the high associated morbidity, causes a decrease in the patient’s quality of life and mobility.

In Aesthetic Medicine Unit we have introduced an effective protocol for the treatment of this type of pathology. It consistsof the combined use of two innovative techniques in this field: Carboxytherapy and Platelet Rich Plasma.

Carboxytherapy has been shown to promote the closure of these ulcers. The process consists of the application of localized microinjections of CO2 using equipment specially designed for this purpose. This equipment is responsible for controlling the gas flow rate, the dose administered and the injection time. The CO2 is introduced subcutaneously, in the perilesional area of the ulcer, thanks to a fine needle to which the gas arrives through a flexible conduit from the equipment.
How does CO2 work? The hemoglobin present in our blood has more affinity for carbon dioxide than for oxygen. By injecting CO2 into the subcutaneous tissue, it stimulates the blood circulation in the treated area and the red blood cells release the oxygen they carry and load the CO2, thus oxygenating the injured tissue and eliminating the CO2 through the lungs. In turn, CO2 stimulates vasodilation at the level of capillaries in the skin and causes angiogenesis (formation of new blood vessels). Thus, by increasing the speed of blood flow and providing greater oxygenation to the injured tissue, ulcers heal faster.
Platelet Rich Plasma (PRP)has proven to be one of the most effective treatments in the healing and repair of chronic skin ulcers. The procedure consists of the intradermal injection of a complex derived from platelet-rich plasma, obtained by means of a conventional blood extraction from the patient himself and which, after a process of ultracentrifugation and with the addition of specific substances, is injected into the ulcer bed and the perilesional skin.
How does PRP act on the ulcer? PRP is a portion of autologous plasma (i.e., the patient’s own blood) with a higher than baseline platelet concentration. These platelets contain Platelet Growth Factors, which are the ones that collaborate in the tissue repair process. Thus, they have a strong influence on the reparative phenomena of wounds. In addition to this, PRP has other advantages over other treatments: it reduces the risk of ulcer infection and pain.
The protocol used in the Aesthetic Medicine Unit consists of a monthly PRP session until completing a total of 3 sessions and two weekly carboxytherapy sessions until the ulcer is completely closed.