TREATMENT OF ELDERLY PATIENTS WITH VARICOSE TROPHIC ULCERS

Abstract

Background. At present, researchers do not have a consensus on the hemodynamic significance of individual blood refluxes in ulcer formation, although a large number of works are devoted to the study of macrohemodynamic factors for the development of trophic disorders in chronic venous insufficiency.

Material and methods. The work is based on the results of a comprehensive examination and surgical treatment data of 167 patients with varicose veins of the lower extremities who were treated in the multidisciplinary clinic of the Tashkent Medical Academy during 2012 - 2022.

Results. The triggering mechanism for the development of trophic varicose ulcers is high venous hydrostatic pressure, but the transition from tissue lipodermosclerosis to open venous ulcer of varicose origin occurs as a result of impaired microcirculation in the soft tissues of the extremity, and not an additional change in hemodynamics in the large great vessels. As a result of the research, it was revealed that changes in microcirculation in chronic venous insufficiency are characterized by local tissue hypoxia in the lower third of the tibia, manifested by a significant decrease in the partial oxygen tension of tissues in the area of trophic ulcers, despite an increase in blood in the microcirculatory bed. Changes in the microcirculation of the skin and subcutaneous tissue in this category of elderly patients are also general, associated with hemorheological disorders and detected in various segments of the extremities.

Conclusion. As a result of ultrasound examinations, various variants of the prevalence of blood refluxes in the venous system of the lower extremities were found, leading to the development of phlebohypertension in elderly patients with venous trophic ulcers.