Results of surgical treatment of patients with chronic venous insufficiency in stage c6 and c6r
DOI:
https://doi.org/10.11603/2414-4533.2021.2.12295Keywords:
chronic venous insufficiency, surgical treatment, VCSS, VDS, VSDSAbstract
The aim of the work: to improve the results of surgical treatment of patients with chronic venous insufficiency in stage c6 and c6r by accelerating the healing of active trophic wounds.
Materials and Methods. The results of treatment of 97 patients with chronic venous insufficiency with C6 (open trophic wound) and C6r (recurrence of open trophic wound) class (CEAP classification) were evaluated. Patients for reliable evaluation of the obtained results were divided into two experimental groups: retrospective 50 (51.55 %) who underwent classical surgical treatment (ligation of perforating veins by Coquett, phlebectomy by Narat) and prospective 47 (48.45 %) who underwent classical surgery (cryectomy + phlebectomy according to Bebcock and/or Narat) in combination with the developed method of treatment of trophic wounds. Mapping of pathologically altered areas and marking for surgical treatment were mandatory. Postoperative monitoring was performed 1 month and 1 year after surgery. The result was evaluated when compared with the scales VCSS, VDS, VSDS.
Results and Discussion. The average score of clinical severity before surgery (VCSS) was equal in the prospective group – (18.03±1.42) points, anatomical score (VSDS – segmental reflux score) was – (3.25±0.14) points, physical activity VDS) – (1.75±0.10) points. Summarizing these indicators, the average severity of the disease was (VSS) – (23.03±2.06) points. Analyzing the indicator of the average severity of the disease (VSSS) during the year of observation, a significant decrease was observed in 1 month after the surgical treatment according to his own method. Thus, it was found that after 3 months this indicator decreased in this group by 2.62 times, after six months – 3.54 times and 1 year after surgery – by 5.68 times (p≤0.001). In both experimental groups, the average value of the “number of active wounds” before surgery was (1.89±0.06) points in the prospective group and (1.92±0.08) points in the retrospective group, respectively, indicating the presence of an average almost 2 active wounds in one patient. After the treatment in the prospective group there was a rapid dynamics of healing of wound surfaces after 1–3 months of postoperative treatment.
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