COMPARISON OF ENDOVASCULAR AND STRIPPING METHODS IN COMBINATION WITH PROLONGED INTRAVENOUS INFUSION THERAPY OF LIDOCAINE IN TREATMENT OF CHRONIC VENOUS INSUFFICIENCY
DOI:
https://doi.org/10.11603/2414-4533.2024.1.14649Keywords:
VCSS, VDS, VSDS, varicose veins, active trophic ulcersAbstract
The aim of the work: to compare the results of using endovascular and classical stripping methods in combination with intravenous administration of lidocaine solution for the treatment of chronic venous disease in the stage of trophic wounds.
Materials and Мethods. The results of treatment of 78 patients with chronic venous insufficiency in stage C6 and C6r were evaluated. Subjects were divided into two clinical groups: group 1 - endovenous laser ablation (n=31) and group 2 (n=47) – classical surgical intervention (high ligation + great saphein vein stripping). In both groups method of prolonged intravenous lidocaine 2 % solution injection was used according to the proposed method. Postoperative monitoring was performed 1, 3, 6 months and 1 year after the surgical treatment. The result was evaluated when compared with the VCSS, VDS, VSDS scales.
Results and Discussion. The dynamics of the pain syndrome when evaluated after 1, 3, 6 months generally showed its rapid regression among patients of both groups. In both experimental groups, the average value of the "number of active ulcers" before surgical treatment was (1.89 ± 0.06) points in the prospective group and (1.92 ± 0.08) points in the retrospective group, respectively, which indicated the presence of an average almost 2 active ulcers in one patient. After the treatment in group 1, rapid dynamics of healing of the wound surfaces was observed already after 1-3 months of postoperative treatment. While in group 2, after 6 months, somewhat slower dynamics were observed. In the same group, a year after treatment, the presence of recurrence of active trophic ulcers was noted in 10 % of patients.It was established that the combination of minimally invasive methods of treatment of varicose veins with endovenous laser coagulation in combination with prolonged administration of lidocaine solution significantly accelerates the healing of trophic wounds. At the same time, analyzing the indicators of the VCSS, VDS, VSDS scales, significantly better clinical indicators were established in terms of follow-up up to 1 year.
References
Dere K, Sen H, Teksoz E, Ozkan S, Dagli G, Sucullu I, Filiz AI, Ipcioglu OM, Kucukodaci Z. The comparison of the effects of different doses of levobupivacaine infiltration on wound healing. J Invest Surg. 2009;22: 112-6.
Fedder C, Beck-Schimmer B, Aguirre J, Hasler M, Roth-Z’graggen B, Urner M, Kalberer S, Schlicker A, Votta-Velis G, Bonvini JM, Graetz K, Borgeat A. In vitro exposure of human fibroblasts to local anaesthetics impairs cell growth. Clin Exp Immunol. 2010;162: 280-8.
Gujja K, Kayiti T, Sanina C, & Wiley JM. Chronic venous insufficiency. Interventional Cardiology: Principles and Practice, 2022; 835-43.
Liakhovskyi VІ, Riabushko RM, Sydorenko АV. Surgical treatment of complicated forms of chronic venous insufficiency in lower limbs. Aktualn probl such med: Visn Ukr med stomat akad. 2020;20(4): 209-15.
Lurie, F., Passman, M., Meisner, M., Dalsing, M., Masuda, E., Welch, H., ... & Wakefield, T. The 2020 update of the CEAP classification system and reporting standards. Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2020;8(3): 342-52.
Nietgen GW, Chan CK, Durieux ME. Inhibition of lysophosphatidate signaling by lidocaine and bupivacaine. Anesthesiology. 1997;86: 1112-9.
Rodrigues FV, Hochman B, Wood VT, Simões MJ, Juliano Y, Ferreira LM. Effects of lidocaine with epinephrine or with buffer on wound healing in rat skin. Wound Repair Regen. 2011;19: 223-8.
Santler B, Goerge T. Chronic venous insufficiency–a review of pathophysiology, diagnosis, and treatment. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 2017;15(5): 538-56.
Suxodolya AI, Suxodolya SA, Kolomiyecz OV, Krelov KYu. Methods of treatment of trophic ulcers when chronic venous insufficiency. (2018). A61B 17/00, A61M 25/01 (2006.01), A61K 31/167 (2006.01), A61P 17/02 (2006.01). Patent for utility model № 117797. byul. № 18/2018. Ukrainian.
Vasseur PB, Paul HA, Dybdal N, Crumley L. Effects of local anesthetics on healing of abdominal wounds in rabbits. Am J Vet Res. 1984;45: 2385-8.
Woo MS, Park J, Ok SH, Park M, Sohn JT, Cho MS, ... & Kim YA. The proper concentrations of dextrose and lidocaine in regenerative injection therapy: in vitro study. The Korean Journal of Pain, 2021;34(1): 19-26.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 О. В. КОЛОМІЄЦЬ, А. І. CУХОДОЛЯ
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:
- 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.
- 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.
- 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)
