Сomplex surgical treatment of trophic ulcers of the lower extremities in chronic venous insufficiency

Abstract

The treatment of 85 patients with varicose veins complicated by trophic ulcers with chronic venous insufficiency
(CHV, C6A) was analyzed.
The aim of the study is to improve the complex surgical treatment of trophic ulcers of the lower extremities in chronic venous
insufficiency using medication, ozone therapy, and bandages.
Materials and methods. Operative treatment of patients was carried out, which included: laser electrocoagulation of
superficial veins (15 minutes), removal of small and large subcutaneous veins (31 minutes), Linton's operation (23 minutes), skin
graft according to Thirsch (16 minutes). The age of the patients ranged from 46 to 78 years, there were 58 women (67.8%), 27
men (32.2%). All patients underwent an ultrasound examination of the vessels of the lower extremities, the extent of ostial reflux,
the condition of the superficial main veins, their inflow, the diameter of the perforating veins, and the diameter of the varicose
veins were also determined. Ointment bandages (Levosyn, Levomekol, Betadine, Fluciderm, Kuriosin), ozonated amaranth oil
were applied locally. Wounds were ozonated in a plastic container with average ozone doses of 2000 μg /l for 7-10 days.
Results. Complex surgical treatment depended on an individual approach to each specific patient with trophic ulcers. The
average duration of preoperative preparation was 5-8 days. The average bed-day was 18.4 days (p<0.05). 71.7% of patients were
discharged from the hospital with healed trophic ulcers; 28.3% of patients with granulation wounds of small sizes are in the
stage of epithelialization and are referred for further outpatient treatment.