Клинический случай лечения венозной трофической язвы

Abstract

Introduction. Varicose veins of the lower extremities with clinical form C2 and higher (if we take into account the modern international classification) is a slowly progressive disease. It needs therapy, besause if untreated, some complications can develop, such as: trophic disorders (lipodermatosclerosis, skin hyperpigmentation, trophic ulcers), bleeding from varicose veins with minimal trauma, thrombotic complications (varicothrombophlebitis, deep vein thrombosis, pulmonary embolism). Materials and methods. This article presents a description of a clinical case of an aged patient with a trophic ulcer of the lower third of the left leg against the background of varicose veins of the lower extremities in the saphenous vein system and the presence of concomitant moderate iron deficiency anemia, ischemic heart disease and hypertension. Considering these factors, endovenous radiofrequency ablation of the great saphenous vein and micro-foam echosclerotherapy of incompetent perforating veins of the leg were performed. Results and discussion. Our clinical observation of an aged patient with moderate iron deficiency anemia, ischemic heart disease and hypertension is an example of effective treatment of trophic ulcers against the background of varicose veins of the lower extremities in the saphenous vein system. Without waiting for the complete compensation of the anemia, the patient was operated on with a minimally invasive method, which contributed to the rapid healing of the trophic ulcer. As a result, after 2 weeks, the trophic ulcer decreased by 2 times, and 1 month after surgery and a 14-day course of infusion vascular therapy, the ulcer completely healed. Conclusion. Thus, in patients with an open trophic ulcer, the elimination of reflux (vertical and / or horizontal) at the initial stage of treatment creates ideal conditions for the fastest healing of the ulcer. The combination of minimally invasive methods of treatment (radiofrequency ablation and micro-foam sclerotherapy) and vascular therapy promotes rapid healing of trophic ulcers, shortens the recovery time of the body against the background of comorbid pathology, and provides a good cosmetic effect.