POSSIBILITIES OF TREATMENT OF I NFECTED ULCERS OF THE LOWER EXTREMITIES IN CHRONIC VENOUS INSUFFICIENCY WITHOUT THE USE OF ANTIBIOTICS

2021 ◽  
pp. 21-26
Author(s):  
I. D. Duzhyi ◽  
L. F. Sukhodub ◽  
V. S. Bielai ◽  
S. M. Zhdanov ◽  
Y. M. Loboda
Keyword(s):  
Chronic Venous Insufficiency ◽  
Microbial Contamination ◽  
Venous Insufficiency ◽  
Lower Extremities ◽  
Modern Medicine ◽  
Microbial Association ◽  
Number Of Microorganisms ◽  
Foot Function ◽  
The Cost ◽  
Subjective Sensation

Summary. Introduction. Purulent diseases and purulent complications in modern medicine remain a complex and not always a positive problem, because in the development of such diseases is quite prominent microbial factor. Overcoming the latter is getting harder every year. The urgency of the problem. The fact is that before our eyes, almost exponentially, the number of microorganisms resistant to existing antibiotics is increasing. Not to mention the toxic effects of many of them on certain organs due to their natural tropism, we note allergic effects, individual intolerance and dysbacterial effects, we note that the cost of some drugs for 1–2 days of use is equal to pension (monthly «income» of most retirees). Given this, you need to look for an opportunity to do without the use of antibiotics, which determines the urgency of the problem. Goal. Explore the possibility of treating infected lower extremity ulcers without the use of antibiotics. Materials and methods. The possibility of treating purulent ulcers of the lower extremities on the background of chronic venous insufficiency by using apatite polymeric drainage bandage based on hydroxyapatite supplemented with zinc oxide has been studied. Results and discussion. Polyvalent microbial association was established in 100 % of patients, staphylococcal colonization prevailed in 75 % of them. On 3–4 days of treatment, a decrease in inflammation, regression of symptoms, reduction of microbial insemination, the appearance of signs of repair, improvement of foot function were recorded. Conclusions. 1) The possibility of treating infected wounds by using apatite polymer drainage bandage has been confirmed; 2) On 3–4 days of application of the drainage bandage there is a regression of the inflammatory process in the area of the ulcer; 3) Microbial contamination of the wound surface for 4 days is reduced from 108 to 73.5 CFU/ml; 4) Subjective sensation and foot function improve by 3–4 days of treatment.

scholarly journals Diagnostic possibilities of thermal vision study of trophic ulcers

2020 ◽  
Vol 19 (2) ◽  
pp. 38-42
Author(s):  
G. V. Yarovenko
Keyword(s):  
Conservative Treatment ◽  
Chronic Venous Insufficiency ◽  
Infrared Radiation ◽  
Venous Insufficiency ◽  
Soft Tissues ◽  
Scattered Light ◽  
Life Quality ◽  
Lower Extremities ◽  
Imaging Method ◽  
Thermal Imager

Chronic venous insufficiency is often accompanied by trophic changes in soft tissues. The treatment of such patients is long and often, ineffective. Relapse of a trophic ulcer is about 30% and leads to deterioration of life quality and dissatisfaction with conservative and even surgical treatment. Goal. Objectification of changes in the microvasculature and compensatory the possibilities of collateral circulation in the lower extremities with complicated forms of chronic venous insufficiency. Materials and methods. The studies were carried out on the Linsor installation characterizing the biological tissue by the change of scattered light intensity and on the thermal imager making possible to determine the temperature of a point with an accuracy of 0,001 degrees, followed by software image processing. The examination was performed 3-4 times in the dynamics of the treatment process and before the patient discharge, from a standard distance of 1,5 meters. The soft tissues in 23 patients with chronic venous insufficiency of the lower extremities and the presence of open trophic ulcers was studied. There were 21 women, 2 men, the average age was 45,2±3,6 years. The area of the ulcer defect varied from 5,7 cm² to 15,3 cm². Patients with extensive trophic ulcers (circular) were excluded from the examination, because of absence of ulcer defect epithelization during the period of hospitalization and its visualization by the thermographic method. Results. As a result of the study, we obtained a reduced intensity of infrared radiation of the ulcer surface in all patients. To clearly isolate ulcerative defect from the surrounding tissues, we set the temperature range 35,0–37,5 °C and recalculated the resulting area in cm² (conversion factor 22,73). We studied the microcirculatory changes occurring in the trophic ulcer and surrounding tissues, confirming the need to continue conservative treatment after complete ulcer defect epithelization for at least 7 days, and only after that period the normalized level of infrared radiation was detected and subsequently relapsed trophic ulcers did not occur for a long time. Conclusion. Based on the obtained data, we confirmed the thermal imaging method sensitivity is suitable for assess of microcirculation in the trophic ulcer area; the method provides the possibility to apply it for the dynamics of conservative treatment in patients with complicated forms of chronic venous insufficiency.

scholarly journals Sonography and multislice contrast tomography in the diagnosis of chronic venous insufficiency complicated by trophic ulcers

2021 ◽  
Vol 11 (7) ◽  
pp. 316-323
Author(s):  
O. Kolomiets
Keyword(s):  
Computed Tomography ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Multislice Computed Tomography ◽  
Venous Blood ◽  
Lower Extremities ◽  
Venous System ◽  
Venous Blood Flow ◽  
Planning Stage ◽  
X Ray

Sonography has become the gold standard in the diagnosis of pathological changes in venous insufficiency, however, studies by other scientists indicate the need for a comprehensive study using phlebographic methods. The aim of the work was to compare the results of sonography and multislice tomography in the diagnosis of chronic venous insufficiency complicated by trophic ulcers. Materials and methods. The results of treatment of 97 patients with chronic venous insufficiency in stage C6 and C6r were evaluated. Ultrasound angioscanning of the venous system of the lower extremities at the planning stage of surgical treatment and in the postoperative period (early and after a year of observation) was performed on a digital device of expert class for cardiovascular studies (Toshiba Aplio 500) with 5-10 MHz sensor and appropriate standard software package examination of the venous system of the lower extremities. Multislice computed tomography was performed using X-ray computed tomography (Philips Brilliance 64). The study was performed using X-ray contrast iodine-containing medium (Omnipack-350) at the rate of 1 ml of the drug per kilogram of patient weight. Research results and their discussion. the sonographic study found that the causes of trophic ulcers were impaired venous blood flow in the veins of the lower extremities due to severe varicose transformation and decompensated reflux, and changes in the deep venous system due to thrombosis of the deep veins. Greater sensitivity and specificity of multislice computed tomography in the diagnosis of postthrombotic stenoses and obliterations were found compared with sonographic examination. This method is valuable in the study of the anatomy of the venous system, but does not allow to assess the parameters of hemodynamics (duration and degree of reflux, but only its presence).

scholarly journals The Influence of Compressive Stockings on the Haemodynamics in the Lower Extremities

1988 ◽  
Vol 3 (3) ◽  
pp. 147-154 ◽  
Author(s):  
A.J.M. Brakkee ◽  
J.P. Kuiper
Keyword(s):  
Healthy Subject ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Venous Pressure ◽  
Lower Extremities ◽  
Limb Volume ◽  
Pump Function ◽  
Muscle Pump ◽  
Elastic Stocking ◽  
Tissue Compression

The influence of an elastic stocking upon the venous muscle pump function in a healthy subject and in a patient with chronic venous insufficiency is discussed. Taking into account the alinear relationship between venous pressure and limb volume the experiences concerning the effects of tissue compression, some of which seem to be contradictory, are clarified.

Acroangiodermatitis

2016 ◽  
Vol 106 (5) ◽  
pp. 364-369
Author(s):  
Anna L. Hronek ◽  
Seth N. Clark ◽  
Gregg Young ◽  
Daniel Kinikini ◽  
Jason Wells
Keyword(s):  
Chronic Venous Insufficiency ◽  
Kaposi's Sarcoma ◽  
Venous Insufficiency ◽  
Lower Extremities ◽  
Kaposi’S Sarcoma ◽  
Histopathologic Examination

Acroangiodermatitis (AAD), also known as pseudo-Kaposi's sarcoma, is an uncommon benign angioproliferative condition most commonly seen in the lower extremities. This condition often presents as discolored patches that progress to painful ulcerations. The list of vascular conditions associated with this diagnosis is vast. Acroangiodermatitis presents similarly to more aggressive conditions such as Kaposi's sarcoma, making histopathologic examination helpful in its diagnosis. We present two cases of AAD in the setting of chronic venous insufficiency.

scholarly journals Differential diagnosis and treatment of edema of lower extremities

2019 ◽  
Vol 2 (27) ◽  
pp. 35-41
Author(s):  
N. V. Orlova
Keyword(s):  
Differential Diagnosis ◽  
Clinical Study ◽  
Hydrostatic Pressure ◽  
Osmotic Pressure ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Capillary Permeability ◽  
Lower Extremities ◽  
Search Algorithms ◽  
Colloidal Osmotic Pressure

The article gives a definition, classification and mechanisms for the development of edema (increased hydrostatic pressure, increased capillary permeability, decreased colloidal osmotic pressure). The main diseases accompanied by edematous syndrome are considered, diagnostic search algorithms are given. The clinic and treatment of edema of the lower extremities due to lymphatic and venous insufficiency are separately discussed. The data of a clinical study of the effectiveness of drugs based on diosmin and hesperidin in the treatment of chronic venous insufficiency are presented.

scholarly journals Results of complex treatment of patients with knee osteoarthritis and varicose diseases of the lower extremities

2012 ◽  
Vol 93 (4) ◽  
pp. 606-611
Author(s):  
E A Shcheglov
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Clinical Signs ◽  
Lower Extremities ◽  
Knee Joints ◽  
Osteoarthritis Of The Knee ◽  
Complex Treatment ◽  
Vascular Surgeon ◽  
Results Of Treatment ◽  
Cardio Vascular

Aim. To evaluate the results of complex treatment with application of methods of correction of chronic venous insufficiency in patients with osteoarthritis of the knee joints in combination with varicose disease of the lower extremities. Methods. Examination of a cardio-vascular surgeon, orthopedist or rheumatologist, triplex scanning the veins of the lower extremities, arthrosonography and X-ray imaging of the knee joints, assessment of the severity of chronic venous insufficiency according to a CEAP scale [Clinical signs, Etiologic classification, Anatomic distribution, Pathophysiologic Dysfunction (1984)], and the degree of gonarthrosis according to the special Leken’s index and WOMAC index (Western Ontario and McMaster Universities Arthritis Index). The investigations were performed before treatment and repeatedly during the year in the course of treatment. According to the indications both conservative therapy and surgical treatment were used. Results. As a result of the complex treatment of patients achieved was a reduction in the severity of symptoms of gonarthrosis, which manifested with a decrease in the total value of the Leken’s index and the WOMAC functional index. Positive results were obtained in the group of patients who underwent surgery, and in the group of patients who received conservative treatment. Conclusion. Inclusion in the treatment of the methods aimed at eliminating manifestations of chronic venous insufficiency leads to improved results of treatment of osteoarthritis of the knee joints.

The Beneficial Augmentative Effect of Micronised Purified Flavonoid Fraction (MPFF) on the Healing of Leg Ulcers: An Open, Multicentre, Controlled, Randomised Study

1999 ◽  
Vol 14 (4) ◽  
pp. 151-157 ◽  
Author(s):  
W. Gliński ◽  
B. Chodynicka ◽  
J. Roszkiewicz ◽  
T. Bogdanowski ◽  
B. Lecewicz-Toruń ◽  
...  
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Venous Ulcer ◽  
Control Group ◽  
Cure Rate ◽  
Randomised Study ◽  
Venous Ulcers ◽  
The Mean ◽  
Flavonoid Fraction ◽  
The Cost

Objective: To determine the increase in healing rate of venous ulcer in patients receiving a micronised purified flavonoid fraction (MPFF) as supplementation to standard local care. Design: A randomised, open, controlled, multicentre study. Setting: Departments of Dermatology and University Outpatients Clinics. Patients: One hundred and forty patients with chronic venous insufficiency and venous ulcers. Intervention: Patients received standard compressive therapy plus external treatment alone or 2 tablets of MPFF daily in addition to the above treatment for 24 weeks. Main outcome measure: Healing of ulcers and their reduction in size after 24 weeks of treatment. Results: The percentage of patients whose ulcers healed completely was found to be markedly higher in those receiving MPFF in addition to standard external and compressive treatment than in those treated with conventional therapy alone (46.5% vs 27.5%; p<0.05, OR = 2.3, 95% CI 1.1–4.6). Ulcers with diameters <3 cm were cured in 71% of patients in the MPFF group and in 50% of patients in the control group, whereas ulcers between 3 and 6 cm in diameter were cured in 60% and 32% of patients ( p<0.05), respectively. The mean reduction in ulcer size was also found to be greater in patients treated with MPFF (80%) than in the control group (65%) ( p<0.05). The cost-effectiveness ratio (cost per healed ulcer) in the MPFF group was €1026.2 compared with €1871.8 in the control group. Conclusions: These results indicate that MPFF significantly improves the cure rate in patients with chronic venous insufficiency.

An evaluation of the lower extremity muscle strength of patients with chronic venous insufficiency

2015 ◽  
Vol 31 (3) ◽  
pp. 203-208 ◽  
Author(s):  
Cem Cetin ◽  
Mustafa O Serbest ◽  
Sabriye Ercan ◽  
Turhan Yavuz ◽  
Ali Erdogan
Keyword(s):  
Muscle Strength ◽  
Lower Extremity ◽  
Visual Analog Scale ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Plantar Flexion ◽  
Lower Extremities ◽  
Analog Scale ◽  
Lower Extremity Muscle ◽  
Significant Difference

Objective In this study, the aim was to evaluate the lower extremity muscle strength in patients with chronic venous insufficiency using an isokinetic dynamometer. Methods The study comprised a group of 36 lower extremities of 23 patients diagnosed with chronic venous insufficiency and a control group of 40 lower extremities of 20 patients who did not have chronic venous insufficiency. In the diagnosis and evaluation of chronic venous insufficiency, photoplethysmography was used to evaluate the venous return circulation time. Visual Analog Scale scoring was applied to define the level of pain of the patients. Muscle strength measurements were made in all the lower extremities by using an isokinetic dynamometer. Results A statistically significant difference was detected between the groups in terms of the muscle strength parameters in the ankle plantar flexion, and knee flexor and extensor muscles. However, no statistically significant difference was found between the groups in the ankle dorsiflexion muscle strength parameters. A significant difference was determined in the ratio of ankle dorsiflexion/plantar flexion muscle strength between the mild, moderate and severe venous insufficiency groups. A statistically considerable negative correlation was found between the Visual Analog Scale scores and the photoplethysmography results. According to the Visual Analog Scale results, as the degree of venous insufficiency increased, so did the level of pain. Conclusion Impaired lower extremity muscle strength was observed in chronic venous insufficiency patients. Although the current study was consistent with literature in respect of impaired calf muscle strength, this finding was also seen in the thigh muscles. Furthermore, we concluded that if venous insufficiency becomes more severe, impaired calf muscle strength becomes more evident.

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