Trophic ulcers of venous etiology and their treatment tactics by endovasal laser coagulation

Abstract

The main goal of the study was to identify a unified and pathogenetically justified method of surgical treatment of patients with trophic ulcers of venous etiology, as well as an algorithm for preoperative preparation of such patients for minimally invasive intervention. The article presents the results of the treatment of trophic ulcers of venous etiology by endovenous laser coagulation. In a comparative aspect, modern data on its effectiveness are presented, the success of this operation is 93–100 %. When comparing the results of using lasers with different wavelengths and energies, the incidence of severe complications (deep vein thrombosis, thrombophlebitis, pulmonary embolism, skin burn) ranges from 0.1 to 2.4 %. In the analysis of the literature, no evidence was found that the wavelength affects the clinical outcome, but the power of the laser energy used matters. The main elements of preparation and performance of operative interventions aimed at elimination of venous blood reflux in lower extremities are indicated, and therapeutic tactics for healing of soft tissue defect in postoperative period are determined.