PhD, senior researcher, Institute of experimental biology and medicine, graduate school of General surgery, head of Department of outpatient surgery
кандидат медицинских наук, старший научный сотрудник НИИ экспериментальной биологии и медицины, соискатель кафедры общей хирургии, заведующая отделением амбулаторно-поликлинической хирургии БУЗ В
MD, Professor, head of Department of General surgery
доктор медицинских наук, профессор, заведующий кафедрой общей хирургии
Relevance. Trophic ulcers on the background of systemic diseases are characterized by long flow and cause greater difficulties in treatment due to the reduced regenerative capabilities of the body. As a result of taking hormones muscles and skin become atrophic changes. Thinning and dry skin are particularly susceptible to trauma. Trophic ulcers in systemic connective tissue diseases often have no specific signs. Indicate systemic disease can atypical localization (thighs, buttocks, torso, upper extremity, head, mucosa of the oral cavity) wound, long for ulcers, with no tendency to regenerate, the big help in diagnostics renders the identification of syndromes, evidence of systemic autoimmune lesions of organs and tissues (polyarthritis, polyserositis, damage internal organs).
Purpose: description of the case of the treatment of the patient with Sjogren disease.
Materials and methods. In this report a clinical case of treatment of ulcers of the tibia on the background of long-term hormonal therapy. Patient more than 20 years of suffering from Sjogren's disease. Diagnosis of Sjogren’s disease (chronic, moderate activity (II) expressed stage), dry keratoconjunctivitis, parenchymatous parotitis, xerostomia, Raynaud's Syndrome, trophic ulcer of left tibia and varicose disease of the lower extremities, 2.
Sjogren’s disease - a systemic autoimmune disease characterized by involvement of exocrine glands, mainly salivary and lacrimal, with the gradual development of secretory failure, combined with various systemic manifestations. Local treatment of trophic ulcers took place against the background therapy of the underlying disease. In the first stage for cleansing the surface of trophic ulcers used for the contact controlled cryodestruction was carried out hydropressing treatment of the wound. The result - on the 5th day the wound was completely cleansed from necrotic tissue. Further, the local treatment consisted in the creation of optimal conditions for regeneration. After 4 weeks the wound is almost completely epithelization.
Conclusions. When Sjogren's disease treatment of ulcerative defects of the skin of the lower extremities takes place on the background of long-term hormonal medications. An important condition for wound healing is to decrease the dose of hormones to the minimum necessary. In this clinical observation in local treatment was applied the technique of contact controlled cryodestruction of pathological tissues on the surface of the ulcer.
Болезнь Шегрена - системное аутоиммунное заболевание, характеризующиеся поражением экзокринных желез, преимущественно слюнных и слезных, с постепенным развитием их секреторной недостаточности, в сочетании с различными системными проявлениями. Местное лечение трофической язвы проходило на фоне терапии основного заболевания. На первом этапе для очищения поверхности трофической язвы использовали метод контактной контролируемой криодеструкции, проводилась гидропрессивная обработка раны. В результате - на 5 сутки рана полностью очистилась от некротических тканей. Далее местное лечение заключалось в создании оптимальных условий для регенерации. Через 4 недели рана практически полностью эпителизировалась.