Topical therapy for complex treatment of chronic venous insufficiency

Abstract

This article presents a review of the current literature on the problem of topical therapy in the complex treatment of chronic venous insufficiency. The relevance of the study of this pathology is due to the prevalence of the disease in the world and in Russia in particular, with progression and decompensation often leading to disability. Modern therapy consists of two components – surgical treatment and conservative therapy with an emphasis on pharmacotherapy. Pharmacotherapy is aimed at phleboprotective, anti-edema and anti-inflammatory actions. The article provides a classification of the main phleboprotective drugs on the Russian market. However, comprehensive treatment of chronic venous insufficiency is not possible without the use of topical agents that have distracting and therapeutic effects. The use of ointments, gels has local anti-inflammatory, anti-edema and capillary-protective effects, which helps to alleviate the clinical symptoms of the disease. In the treatment of chronic venous insufficiency, various topical preparations of combined action are used. One of them is a gel based on an effective combination of troxerutin and indomethacin, which has a pronounced angioprotective, analgesic, anti-edema and anti-inflammatory effect, which leads to improvement of soft tissue trophism in the affected area. Clinical case is presented: patient N., 47 years old with the diagnosis “varicose vein disease of the lower extremities, сlosed trophic ulcer on the medial surface of the middle third of the left tibia, сhronic venous insufficiency according to CEAP C6”. The patient has a 12-year history of varicose veins of the lower extremities, for which he had not been operated on before. During the last 3 years before his admission to hospital the patient had an open trophic ulcer on the medial surface of the middle third of the left tibia, for which he was treated outpatiently with positive dynamics. During the last 6 months, the ulcer closed, but pain, hyperaemia and oedema persisted. In the postoperative period, along with phleboprotective agents, the patient received topical treatment using Troximetacin gel 3–4 times a day for a treatment course of 10 days. During the period of observation pain syndrome was reduced, hyperemia and swelling were eliminated, the patient had no complaints. Correction of chronic venous insufficiency is multicomponent, including surgical correction, pharmacotherapy and topical therapy. Modern topical agents have proven to be effective due to their polyvalent mechanism of action.