OPTIMIZATION OF SURGICAL TREATMENT OF DECOMPENSATED FORMS OF VARICOSE DIEASE OF THE LOWER EXTREMITIES

Objective. Determination of the effectiveness of using a combined method of treatment of varicose veins of the lower extremities with trophic ulcers, including surgical correction of pathological venous reflux and primary plasty of the ulcer with an autovenous flap. Materials and methods. The examination and analysis of the results of treatment of 46 patients with varicose veins of the lower extremities with trophic ulcers on the medial surface of the shin was carried out. The total number of men was 18 (39.1%), women - 28 (60.8%). The average age is 42.5 ± 18.3 years. The average area of trophic ulcers was 11.0 ± 3.5 cm2. A comparative analysis of the results of combined treatment according to the proposed procedure with the use of autovenous ulcer plasty in comparison with conventional tactics was made. Results and discussion. During follow-up in the postoperative period in the patients of the study group, signs of flap adhesion to the ulcer surface were noted on the first day in 21 patients. One patient underwent a disposition of the flap, which resulted in incomplete adhesion of the autovenous fragment, which was noted with the change of dressings on the third day. All patients underwent transformation of an autovenous flap into a scab that covers the surface of the ulcer within 7 days. At the same time, there was a significant reduction in the pain syndrome in the ulcer in the postoperative period compared with the control group. The rejection of the scab in patients of the study group was observed at a time of 23 ± 7.2 days. In 18 patients (79.9%), the ulcer was in the phase of epithelialization. In terms of up to 1 month, ulcers completely healed in 19 patients (90.1%) of the study group and 11 patients in the control group (45.8%).