Efficacy of ultraphonophoresis with an enzyme gel with high transcutaneous and proteolytic activity in patients with atrophic skin scars: a prospective interventional cohort comparative study

Abstract

Introduction. The trend towards an increase in peacetime and wartime injuries and the frequent formation of severe cicatricial dysplasia dictate the need to develop an effective, universal, and widely available method for the prevention and correction of fibrotic skin deformities applied by doctors of various specialties: dermatocosmetologists, physiotherapists, and rehabilitologists. In addition to persistent irreversible structural damage and a visible skin defect, patients are concerned about itching and other subjective sensations in the scar area. Physical methods of correction using transdermal deliveries of enzyme fibromodulatory drugs are scientifically substantiated and are widely used in the rehabilitation period of patients with scars of various origins. Meanwhile, the therapeutic possibilities of influencing the subjective sensations of this group of patients remain only partially studied up to date. Materials and methods. A prospective interventional cohort comparative study of the efficacy and safety of using the ultraphonophoresis technique with an enzyme gel with a high transcutaneous and proteolytic ability in patients with atrophic skin scars was carried out. The study included 56 patients with a diagnosis of «atrophic scars» (ICD-10 Chapter XII: Diseases of the skin and subcutaneous tissue, L90). The entire sample was divided into groups with developing (n=27) and mature (n=29) scars. As a result of random distribution, the study subgroups (groups 1, 3 n=14 and n=15) and comparison subgroups (groups 2, 4 n=13 and n=14), in which the patients were prescribed topical therapy with traditionally used anti-scar drugs, were formed. During the study, clinical, instrumental, and medico-sociological research methods were used. Results. In the study groups, a high safety profile of gel ultraphonophoresis procedures and more significant changes in the macro-relief of the scar, instrumental indicators, and quality of life indicators have been established. Conclusion. The method of ultraphonophoresis with an enzyme gel with high transcutaneous and proteolytic activity in patients with atrophic skin scars has been scientifically substantiated and tested. The effectiveness of the treatment complex is 84–88 %.