Trophic Ulcers of the Lower Extremities: Possibilities of Conservative Treatment

Abstract

The purpose of the study was to evaluate the effectiveness of low-intensity laser radiation in the complex treatment of trophic ulcers of the lower extremities in patients with varicose veins based on objective criteria. Materials and methods. Clinical and histomorphological studies were performed on patients aged 15 to 75 years who were treated for small and medium stage II ulcers on the lower extremities at the Training and Surgical Clinic of the Azerbaijan Medical University and the Central Hospital of the Gazakh region. The criteria for inclusion in the study were men and women of the above mentioned age, and the presence of ulcerative necrotic lesions of the lower extremities. The exclusion criteria were heart failure, systemic diseases, oncological diseases, hormone therapy, and pregnancy. The patients included in the study groups were comparable in age and sex characteristics, the volume of ulcerative lesions of the lower extremities, the duration of the disease and the somatic state. In the main group, in the treatment of trophic ulcers of the lower extremities of small and medium sizes, Venocoryl ointment, low-intensity laser radiation and endovenous laser ablation using a modified ptfe-coated cylindrical light guide were used. The control group included 25 patients, in whose regional treatment only standard retro-specific methods of treatment using endovenous laser ablation were used. The comparison group included 25 patients who underwent endovenous laser ablation and were prescribed Venocoryl ointment. The experimental groups included 21 men and 54 women aged 15 to 75 years. Results and discussion. The rate of healing of trophic ulcerative wounds during the second month after the start of therapy in the main group in patients of the main group was 0.131 ± 0.008 cm2 per day, in the comparison group – 0.125 ± 0.007 cm2; in the control group – 0.072 ± 0.004 cm2 per day. When observing patients for up to 6 months, the following was noted: in the main group, after the application of the laser, it was possible to completely heal the wound defect in 21 patients (84%) in the main group, 17 patients in the comparison group (68%) and 13 patients in the control group (52%). In the course of the research, it was found that in the main group for the first month there is an active process of epithelization and a reduction, against this background, of the ulcer, and, despite the decrease in the rate of reparative processes in this group, the ulcer epithelializes much earlier and faster. Conclusion. The high rate of healing with the use of laser radiation, compared with standard treatment, was maintained throughout the study period