Behaviour in Chronic Wounds of Vascular Origin

Abstract

With an ageing population the number of people with chronic limb wounds of vascular origin is growing steadily. These wounds are managed conservatively, surgically and with hybrid approach. They have been treated by different specialists. The aim of the present study was to compare the results between the different methods of treatment – conservative, surgically and with hybrid approach, as well as to offer an approach to these wounds from vascular origin based on our experience in the clinic. For a period of 3 years 220 patients with venous wounds have been accepted in the department of vascular surgery in UHAT “St. Ekaterina”, Sofia. One hundred of them have been treated conservatively, the rest 120 – with complex approach – surgically, pharmaceutically, elastopia or with bandages. The rate of ageing ulcuses of venous origin did not differ significantly in 3 months in the two groups (55% to 66%), on account of recurrences at 12-month follow-up, which were significantly more common in the conservative therapy group (15% to 30%). We have followed-up the frequency of the healed wounds on the 1st, 3rd and 6th month. A significant difference in healing wounds of vascular origin with a complex approach (with open surgery and conservatively) even during the 1st month has been noticed. The complex approach applied as a treatment of chronic wounds with vascular origin is particularly important. The surgical or interventional correction of pathological changes of the vascular system are of great importance for the successful treatment of these ulcuses.