Journal «Angiology and Vascular Surgery» • 

2020 • VOLUME 26 • №1

Comprehensive treatment of indolent trophic ulcers of venous aetiology

Magomedov M.M.1, Akhmedov I.G.2,3, Magomedov A.A.4, Magomedov M.A.1

1) Department of Surgery, Faculty of Advanced and Primary Medical Training of Specialists,
2) Chair of Hospital Surgery №1, Dagestan State Medical University of the RF Ministry of Public Health,
3) Clinic «Health»,
4) Republican Interregional Multimodality Hospital, Makhachkala, Russia

Objective. The study was undertaken to evaluate efficacy of comprehensive treatment with the use of erbium laser radiation in patients suffering from venous trophic ulcers of lower limbs.

Patients and methods. The study included a total of seventy-six 45-to-80-year-old patients. Of these, there were 43 (56.6%) women and 33 (43.4%) men. The duration of the disease averagely amounted to 10.8±4.8 years. In 38 patients, the bottom of the ulcerative defect was with pronounced periulcerative inflammation and various degree of purulent discharge. All patients were admitted to the surgical department and underwent meticulous examination. Erbium laser irradiation was carried out with consideration for the ulcer size. Laser irradiation was performed at a wavelength of 2940 nm, pulse duration – 0.3 ms, laser beam diameter – 7 mm with radiation power of 2.19 J/cm2.

Results. Efficacy of treatment was assessed in dynamics by the degree of pain syndrome, ulcer size upon completion of treatment, as well as the rate of trophic ulcer epithelialisation. In 15 (19.7%) patients with varicose disease the vertical and horizontal reflux was eliminated with performing phlebectomy and echosclerotherapy. The obtained findings demonstrated that 42 (91.3%) patients of the study group had decreased terms of the beginning of purification of the fundus of the ulcer. After 6 months of rehabilitation and follow up, complete ulcer healing was achieved in 18 (64.3%) patients of the control group and in 39 (86.7%) patients of the study group.

Conclusion. The obtained findings showed that laser radiation proved to be an effective method of treatment in patients presenting with indolent trophic ulcers. Comprehensive treatment made it possible to effectively influence the microflora and the state of regional lymph drainage, to stimulate the processes of reparative regeneration.

KEY WORDS: trophic ulcer, erbium laser, chronic venous insufficiency.

P. 68

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