Algorithm of the Treatment of Venous Trophical Ulcers of Lower Extremities

The work proved to improving the results of treatment of patients with infected venous trophic ulcers, by optimizing the method of surgical correction of venous blood flow and local treatment. The work presents results of treatment of 125 patients with varicose disease C5-C6. The study group consisted of 58 patients who were treated during the first stage of the wound process with the application of modern adsorbing wound dressings, after the transition to the 2nd and 3rd stages of wound healing process, a combination of hydrogel wound dressings with an ointment containing hyaluronic acid and silver sulfadiazine was used. The comparison group consisted of 67 patients, who were treated with traditional methods of treatment, moist drying gauze ointment dressings. It was established that trophic changes of soft tissues on the background of varicose disease are associated with multifunctional reflux in the subcutaneous veins system of the medial shin group. Incompetent perforating veins were identified during doppler ultrasonography in all patients in the chronic ulcer zone or in close proximity. A number of methods for correcting phlebohaemodynamic disturbances by applying minimally invasive surgical techniques for destroying pathological veno-venous refluxes in the presence of infected trophic ulcers are considered. A method for treating patients with infected venous trophic ulcers against a background of varicose veins is proposed by topical application of modern biodegradable wound dressings, depending on the stage of the wound process. The effect of the combination of the use of hydrogel dressings in combination with hyaluronic acid and silver sulfadiosin has been proved, which makes it possible to create an optimal moist environment to ensure pronounced wound healing. After the treatment, there were no signs of infection of the ulcer. The expediency of one-stage surgical treatment with the use of minimally invasive methods is proved. The high efficiency of the proposed methods of surgical and local treatment of patients with complicated forms of varicose veins, based on the reduction of postoperative complications and improvement of all quality of life indicators, is proved; as well as a reduction in the severity of venous dysfunction, assessed using the VCSS scale