COMPREHENSIVE TREATMENT OF CHRONIC WOUNDS OF VASCULAR ORIGIN

Introduction: The number of patients with chronic wounds of vascular origin is constantly rising due to the increased life expectancy of the population. 0.6-3% of the population aged 60 years and over, suffers from chronic wounds of the extremities. Untreated chronic wounds account for most amputations of the lower extremities. Aim: This study aims at presenting the advantages of a comprehensive approach to treatment of chronic wounds of vascular origin based on our experience. Materials and methods: This study comprises of 500 patients, which were treated for chronic wounds of vascular origin at the Clinic for Vascular and Endovascular Surgery at the University Hospital ?St. Ekaterina? in Sofia and the ?German Clinic? Medical Center in Gotze Delchev over a period of 5 years. Prior to their treatment, all patients underwent a complete vascular status assessment in order to determine the origin of their wounds: arterial, venous or mixed. 250 patients received only conservative treatment and 250 patients were assigned to the comprehensive treatment group. Results: We assessed wound healing at 1, 3 and 6 months. Patients in the comprehensive treatment group showed a significant increase in wound healing as early as 1 month after beginning of treatment. Conclusions: The comprehensive approach for treatment of chronic vascular wounds is of great importance. In order to select the appropriate method of treatment, the patients have to be examined by a skilled vascular surgeon or angiologist through a detailed assessment of the vascular system via Doppler examination and angiography.