Treatment experience of chronic leg ulcers of different genesis

Authors

  • S. O. Kosulnikov Municipal Enterprise "I. I. Mechnikov Dnipropetrovsk Regional Clinical Hospital “Dnipropetrovsk Regional Council”
  • O. M. Biesiedin Communal non-profit enterprise “City Clinical Hospital No 4” of the Dnipro City Council
  • D. O. Kisilevsky “Dnipropetrovsk State Medical University of the Ministry of Health of Ukraine”
  • O. V. Sokolov “Dnipropetrovsk State Medical University of the Ministry of Health of Ukraine”
  • S. O. Tarnapolsky Municipal Enterprise "I. I. Mechnikov Dnipropetrovsk Regional Clinical Hospital “Dnipropetrovsk Regional Council”
  • K. V. Kravcheno Municipal Enterprise "I. I. Mechnikov Dnipropetrovsk Regional Clinical Hospital “Dnipropetrovsk Regional Council”

DOI:

https://doi.org/10.11603/2414-4533.2022.2.13046

Keywords:

chronic ulcers, surgical debridement, wound healing

Abstract

The aim of the work: to improve the results of treatment of patients with chronic leg ulcers of various origins by introducing modern diagnostic technologies and wound debridement into clinical practice.

Materials and Methods. The observation group included 125 patients with shin ulcers of different genesis and ulcer area of at least 60 cm, who were treated in the purulent-septic center of Dnipropetrovsk Regional Clinical Hospital named after I. I. Mechnikov from 2015 to 2020.

Results and Discussion. The algorithm of implemented active surgical ulcer debridement, which includes surgical treatment of the ulcer with ultrasonic cavitator, combined with hemodynamic correction of blood flow in the relevant segment, allowed to transfer the wound from chronic to acute and start vacuum therapy on 3.7 days of treatment. When the wound was ready to close, the use of xenodermoimplantation and shave therapy allowed 90 % of patients to achieve complete wound healing with an average hospital stay of 27.5 days. The proposed algorithm for the treatment of chronic leg ulcers after further study and refinement may be recommended for implementation in the joint work of the departments of purulent-septic and vascular surgery.

References

Hedayati, N., Carson, J.G., Chi, Y.-W. & Link, D. (2015). Management of mixed arterial venous lower extremity ulceration: A review. Vascular Medicine, 20 (5), 479-486. DOI: 10.1177/1358863X15594683

Kokhan R.S., Goshchynsky V.B., & Pyatnychka O.Z. (2017). Zastosuvannia suchasnykh tekhnolohii u likuvanni khvorykh iz dekompensovanoiu formoiu varykoznoi khvoroby nyzhnikh kintsivok [Application of modern technologies in the treatment of patients with decompensated varicose veins of the lower extremities]. Ukrainskyi zhurnal khirurhii – Ukrainian Journal of Surgery, 1 (32), 46 [in Ukrainian].

Kosynskyi, O.V., Mariichenko, S.O., Buzmakov, D.L., & Iorzh, T.V. (2019). Obmezhennia zhyttiediialnosti naselennia Ukrainy vnaslidok khronichnykh zakhvoriuvan ven nyzhnikh kintsivok [Restriction of life of the population of Ukraine due to chronic diseases of the veins of the lower extremities]. Sertse i sudyny – Heart and Blood Vessels, 1, 63-66 [in Ukrainian].

Alavi, A., Sibbald, R.G., Phillips, T.J., Miller, O.F., Margolis, D.J., Marston, W., Woo, K., Romanelli, M., & Kirsner, R.S. (2016). What's new: Management of venous leg ulcers: Treating venous leg ulcers. Journal of the American Academy of Dermatology, 74 (4), 643-664. DOI: 10.1016/j.jaad.2015.03.059

Liakhovskyi, V.I., Bezkorovainyi, O.M., & Sydorenko, A.V. (2019). Osoblyvosti likuvannia ta zahoiuvannia trofichnykh vyrazok nyzhnikh kintsivok zmishanoho henezu [Features of treatment and healing of trophic ulcers of the lower extremities of mixed origin]. Klinichna khirurhiia – Clinical Surgery, 86, 7, 36-41 [in Ukrainian].

O’Donnell, T.F., Passman, M.A., Marston, W.A., Ennis, W.J., Dalsing, M., Kistner, R.L., Lurie, F. (2014). Society for Vascular Surgery, & American Venous Forum. Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum. Journal of Vascular Surgery, 60(2), 3-59. DOI: 10.1016/j.jvs.2014.04.049

Conte, M.S., Bradbury, A.W., Kolh, P., White, J.V., Dick, F., Fitridge, R., Mills, J.L., Ricco, J.-B., Suresh, K.R. et al. & GVG Writing Group (2019). Global Vascular Guidelines on the Ma­nagement of Chronic Limb-Threatening Ischemia. European Journal of Vascular and Endovascular Surgery, 58 (1), 1-109. DOI: 10.1016/j.jvs.2019.02.016

Davies, C.E., Woolfrey, G., Hogg, N., Dyer, J., Cooper, A., Waldron, J., Bulbulia, R., Whyman, M.R., & Poskitt, K.R. (2014). Maggots as a wound debridement agent for chronic venous leg ulcers under graduated compression bandages: A randomised controlled trial. Phlebology, 30 (10), 693-699. DOI: 10.1177/0268355514555386

Franks, P.J., Barker, J., Collier, M., Gethin, G., Haesler, E., Jawien, A., Laeuchli, S., Mosti, G., Probst, S., & Weller, C. (2016). Management of Patients With Venous Leg Ulcers: Challenges and Current Best Practice. J. Wound Care, 25 (Sup. 6), 1-67. DOI: 10.12968/jowc.2016.25.Sup6.S1

Genevieve, A. (2017). Benefits of maggot debridement therapy on leg ulcers: a literature review. British Journal of Community Nursing, 22 (Sup. 6), 14-19. DOI: 10.12968/bjcn.2017.22.Sup6.S14

Neumann, H.A. (2017). Evidence-based (S3) guidelines for diagnostics and treatment of venous leg ulcers.Answer to Dr Bertolini. Journal of the European Academy of Dermatology and Venerology, 31 (9), 386. DOI: 10.1111/jdv.14182

Chang, Y.-J.R., Perry, J., & Cross, K. (2017). Low-frequency ultrasound debridement in chronic wound healing: A Systematic Review of Current Evidence. Plast Surg (Oakv), 25 (1), 21-26. DOI: 10.1177/2292550317693813

Norman, G., Westby, M.J., Rithalia, A.D., Stubbs, N., Soares, M.O., Dumville, J.C. (2018). Dressings and topical agents for treating venous leg ulcers. Cochrane Database of Systematic Reviews, 10 (6), 23. DOI: 10.1002/14651858.CD012583.pub2

Rusin, V.V., Nosenko, O.A., Kopolovets, I.I., Kalynych, S.S., & Kochmar, O.M. (2018). Klinichni rekomendatsii z diahnostyky, likuvannia ta profilaktyky venoznykh trofichnykh vyrazok [Clinical guidelines for the diagnosis, treatment and prevention of venous trophic ulcers]. Karpaty. Uzhhorod [in Ukrainian].

Downloads

Published

2022-09-14

How to Cite

Kosulnikov, S. O., Biesiedin, O. M., Kisilevsky, D. O., Sokolov, O. V., Tarnapolsky, S. O., & Kravcheno, K. V. (2022). Treatment experience of chronic leg ulcers of different genesis. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (2), 46–53. https://doi.org/10.11603/2414-4533.2022.2.13046

Issue

No. 2 (2022)

Section

EXPERIENCE OF WORK

License

Copyright (c) 2022 Hospital Surgery. Journal named by L.Ya. Kovalchuk

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  
  2. Лицензия Creative Commons
  3. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  4. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)