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№3' 2014

SURGERY

International Medical Journal, Vol. 20., Iss. 3, 2014, P. 72−75.

Surgical treatment of trophic ulcers at chronic venous insufficiency: individual approach

V. T. Zaitsev Institute of General and Urgent Surgery (National Academy of Medical Sciences of Ukraine), Kharkiv, Ukraine

The aim of our study was to improve the results of treatment of patients with decompensated forms of chronic venous insufficiency by applying differentiated pathogenetically based surgical tactics. Within the period of 2009−2013 102 patients with decompensated forms of chronic venous insufficiency were operated. Presence of trophic disorders of soft tissue tibia of varying severity (CVI C4−6 class CEAP) and insufficient perforating veins of the calf were common. All patients underwent combined surgery including elimination of perforation failure, various modifications of the operation on the superficial veins eliminating vertical reflux. Depending on the method of filling the low horizontal venovenous shunt the patients were randomly divided into two groups. The study group comprised 52 (51 %) patients who underwent subfascial dissection of incompetent perforated veins through a minimal access. The comparison group included 50 (49 %) patients who underwent endoscopic dissection of incompetent perforating veins. The use of pathogenetically differentiated surgical tactics in decompensated forms of chronic venous insufficiency allowed to increase the effectiveness of treatment, to achieve good and satisfactory results in 80.5 % of cases.

Key words: chronic venous insufficiency, trophic ulcer, individual approach.