Complex Approach in the Treatment of Extensive Trophic Leg Ulcers in a Multidisciplinary Hospital

Abstract


Relevance Trophic ulcers of the lower extremities are severe manifestation of ischemic disorders like blood Genesis and manifestation of chronic venous insufficiency.
The purpose of the study Сlinical observations on the treatment of ulcers with NVG disease, diabetic foot syndrome and, as one of the rare cases.
Materials and methods The article analyzes the extensive experience in the treatment of trophic ulcers on the background of chronic venous insufficiency and post-illness and when the diabetic foot syndrome and rare observation of the ulcer Martorella illustrating clinical observations.
Results and discussion In complex treatment of patients with trophic ulcers due to decompensation of CVI and diabetes, effective stimulator of regeneration (Actovegin), and drugs that improve the microcirculation of tissues (Sulodexide) in combination with the use of relevant indications of surgical intervention with removal of pathological veno-venous reflux and adequate surgical correction of arterial ischemia, as well as in combination with a plastic closure ulcers.
Conclusion This approach accelerated healing of trophic ulcers and reduces the total hospitalization of patients. treatment of patients with trophic ulcers requires integrating the efforts of various specialists hospitals, and care. Only under this condition it is possible to successfully implement a comprehensive treatment program required for patients with severe decompensated circulatory disorders of the lower extremities.

N.I.Pirogov Russian National Medical Surgical Center, 70 Nizhniaia Pervomaiskaia St., Moscow, 105203, Russian Federation

Author for correspondence.
Email: DmitriyFedotov1@gmail.com
MD, Academician of RAMS, Prof., President of the N.I. Pirogov National Medical Surgical Center (NMSC)

N.I.Pirogov Russian National Medical Surgical Center, 70 Nizhniaia Pervomaiskaia St., Moscow, 105203, Russian Federation

Email: DmitriyFedotov1@gmail.com
MD, Academician of RANS, professor, main surgeon of NMSC

N.I.Pirogov Russian National Medical Surgical Center, 70 Nizhniaia Pervomaiskaia St., Moscow, 105203, Russian Federation

Email: gudvic@mail.ru
MD, cardiovascular surgeon of NMSC

N.I.Pirogov Russian National Medical Surgical Center, 70 Nizhniaia Pervomaiskaia St., Moscow, 105203, Russian Federation

Email: mail@vestnik-surgery.com
PhD, surgeon NMSC

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  2. Coleridge Smith P.D., Thomas P., Scurr J.H. et al. Causes of venous ulceration: a new hypothesis [Prichiny venoznykh yazv: novaya gipoteza] . Brit. Med. J. 1988; 296: 6638: 1726-1728.
  3. Thomas P.R.S., Nach G.B., Dormandy J.A. White cell accumulation in the dependent legs of patients with ambulatory venous hypertension:а possible mechanism for trophic changes in the skin [Nakopleniye belaya kletka v zavisimykh nogakh patsiyentov s ambulatornogo venoznoy gipertenzii: vozmozhnyy mekhanizm troficheskikh izmeneniy kozhi]. Br. Med. J., 1988; 296: 6638: 1693-1695.

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