Changes in main arterial and venous blood flow and skin microcirculation depending on the amount of medical elastic compression in the treatment of venous trophic ulcer

Authors

  • V. I. Rusyn Uzhhorod National University
  • F. M. Pavuk Uzhhorod National University
  • V. Ya. Fedusyak Uzhhorod National University

DOI:

https://doi.org/10.11603/2414-4533.2022.3.13388

Keywords:

microcirculation, trophic ulcer, varicose disease, angiosome, regional perfusion index

Abstract

The aim of the work: to determine the influence of elastic compression on the venous and arterial velocity of the main blood flow of the lower limb and the skin microcirculation of the anterior part of the foot in the treatment of venous trophic ulcers.

Materials and Methods. 15 patients with varicose veins in the stage of decompensation participated in the study. Among them there were 9 (60 %) women and 6 (40 %) men. The average age of patients was (56±5.7) years. In all study subjects, the ankle-brachial pressure index (ABPI), deep femoral-popliteal index, regional perfusion index, tcpO2, tcpCO2, arterial blood flow velocity in the femoral artery (AFV) and venous blood flow velocity (VFV) distal to the saphenofemoral junction were measured. After the measurements, the following measurements were performed after using elastic medical knitwear of different compression classes.

Results. At the I class of compression (15–21 mmHg), significant changes in indicators by 12 % were found (p<0.01). The arterial blood flow rate decreased by 2 times in comparison with the input data at the maximum pressure of the fourth compression class (p=0.0001). TcpO2 tended to decrease and at the fourth compression class (>46 mmHg) was (61.2±1.3) mmHg (p=0.0001). The value of transcutaneous oxygen pressure decreased with increasing pressure of elastic compression. On the other hand, the values of tcpCO2 have increased significantly already at the 1st compression class (p=0.0001) and continued to increase until the end of the study. Analyzing changes in the transcutaneous pressure of carbon dioxide, it was established that its values increased by 40 % compared to the input data (p=0.0001). RPI values decrease starting from a pressure level of 10 mmHg as well as the tcpO2 indicator, therefore, the use of RPI can serve as a criterion of choice for diagnosing the degree of ischemia.

Conclusions. Venous velocity of blood flow in the femoral vein decreases by 22 % at compression of 15 mmHg, and at the maximum pressure of elastic compression, the decrease in venous velocity compared to the initial value was 78 % (p=0.0001). TcpCO2 significantly increases at compression of 15 mmHg (p=0.0001), also in parallel with the decrease in the regional perfusion index, which begins at external compression of 15 mmHg (p<0.05), which is evidence of deterioration of skin perfusion of the back of the foot in patients with varicose veins in the stage of decompensation.

References

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Published

2022-10-05

How to Cite

Rusyn, V. I., Pavuk, F. M., & Fedusyak, V. Y. (2022). Changes in main arterial and venous blood flow and skin microcirculation depending on the amount of medical elastic compression in the treatment of venous trophic ulcer. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (3), 13–19. https://doi.org/10.11603/2414-4533.2022.3.13388

Issue

No. 3 (2022)

Section

ORIGINAL INVESTIGATIONS

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