CURRENT TREATMENT OF PATIENTS WITH GIANT TROPHIC ULCERS

Yuri Orel, Markiian Verkhola

Abstract


The prevalence of venous ulceration in legs among the population is 0.1-1.5%, in 24% of patients and the duration of their treatment is more than a year. As a result, 45% of patients suffer from limited mobility, and many patients move only within the home. Wound healing rate in specialized centers for 6 months is 70% and 45% - in non-specialized hospitals.

The aim of the study: Reduce the length of hospital stay and the duration of treatment for patients with giant trophic ulcers.

The therapeutic tactics of 13 patients with giant trophic ulcers who were treated during the 2016 in the clinic of the Department of Surgery No. 2 of Danylo Halytsky LNMU were analyzed. Patients had an area of ulcers greater than 150 cm2 without tendency to heal. One-time treatment was carried out, consisting of surgery debridement, removal of fibrous tissue (shave-therapy), autodermoplastics with the use of negative pressure wound therapy (NPWT). The intervention was performed under i.v. or regional nerve blockade. With the use of the NPWT, a patient can be mobilized rather quickly, there is no need for constant bed rest, and with the possibility of adequate and supervision care is transferred to outpatient treatment on the first days. The total term of patients staying in a hospital was from 1 to 6 days. This technique has allowed to achieve a significant improvement in the quality of treatment and reduction of its terms.

Keywords


venous insufficiency; post-thrombotic syndrome; trophic ulcers; circular; autodermoplastics; skin grafting; NPWT; lymphedema; debridement; shave-therapy

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DOI: http://dx.doi.org/10.21303/2585-663.2017.00445

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ISSN 2585-6634 (Online), ISSN 2585-6626 (Print)