TROPHIC ULCERS IN CHRONIC VENOUS INSUFFICIENCY OF THE LOWER LIMB
Keywords:
. Chronic venous insufficiency, trophic ulcers..Abstract
Chronic venous hypertension triggers a cascade of pathological reactions, the end result of which is gross changes in the trophism of the soft tissues of the lower extremities. The main hemodynamic factor leading to hypertension in the superficial venous system and, subsequently, to trophic changes in the lower limb, is the discharge of blood from the deep veins, and it is associated with insufficiency of the valves at the mouth of the great and small saphenous veins (vertical reflux), as well as incompetence perforators (horizontal reflux). Moreover, 90% of the latter are localized in the lower leg area, of which 87% belong to the veins of the Cockett zone I-III
References
Morrison C., Dalsing M.C. Signs and symptoms of saphenous nerve injury after greater saphenous vein stripping: prevalence, severity, and revance for modern pracnice. // J. Vase. Surg. - 2003. - Vol. 16. - P. 2-12. (in Russ).
21st World Congress of the International Union of Angiology, May 22-26, Rome, Italy) // Phlebolymphology.Special issue. - 2014. - №46. - 115 p. (in Eng).
Allegra C., Carlizza A., Bartolo М. Рецидивы варикозного расширения вен нижних конечностей: результаты наблюдения в течении 5 лет. // Флеболимфология - 2016 .- 22. - С. 21-25. (in Eng).
Belcaro G., Casarone M.R., Di Renzo A., Drandolini R. et al. Foam sclerotherapy, surgery sclerotherapy, and combined treatment for varicose veins: a 10 year, prospective randomized, controlled, trial ( VEDICO trial). // Angiology. - 2020. - Vol. 54, №3.- P. 307-315(in Eng).
Beresford Т., Smith J.J., Brown L., Greenhalgh R.M. et al. A comparison of health related quality of life of patients with primary and recurrent varicose veins. // Phlebology.- 2019. - Vol. 18, № 1. - P. 35-37. (in Eng).
Cabrera Garrido J.R., Cabrera Garcia Olmedo J.R., Garcia Olmedo Dominguez M.A. Elargissement des limites de la schlerotherapie: noveaux produits sclerosants. // Phlebologie. - 1997. - Vol. 50. - P. 181-188. (in Eng).
Danielsson G. What is the role of incompetent perforator veins in chronic venous disease? G. Danielsson, B. Eklof, R L. Kistner. // Phlebology. - 2014. -Vol. l.-P. 67-71. (in Eng).
Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. // J Epidemiol Community Health. - 2018. - Vol.53. - P. 149-153. (in Eng).
Grass JD, Hiemer W. Bypass procedures for venous obstruction. In: Raju S, Villavicencio JL, editors. Surgical management of venous disease. // 1st ed. Baltimore: Williams & Wilkins. - 2020. - P. 289-305. (in Eng).
Hurst DR, Forauer AR, Bloom JR, Greenfield LJ, Wakefield TW, Williams DM. Diagnosis and endovascular treatment of iliocaval compression syndrome. // J Vase Surg. - 2021. - Vol. 34. - P. 106-13. (in Eng).
Kahn SR, Ginsberg JS. Relationship between deep venous thrombosis and the postthrombotic syndrome. //Arch Intern Med. - 2018. - Vol. 164,- P. 17—(in Eng).
Lin S-D., Lin T-М., Lee S-S., Yang Y-L. et al. Endoscopeassisted management primary varicose veins below the knee. // Phlebology. - 2016. - Vol. 20, №4.-P. 163-169 (in Eng).
Marston W.A., Owens L.V., Davies s. et al. Endovenous saphenous ablation corrects the hemodynamic abnormality in patients with CEAP clinical clfss 3-6 CVI due to superficial reflux. // Vase. Endovascular Surg. - 2017. - Vol. 40, №1 (in Eng).
Neglen P, Thrasher TL, Raju S. Venous outflow obstruction: an underestimated contributor to chronic venous disease. // J Vase Surg. - 2014. - Vol.38. - P. 879-885. (in Eng).
Pierik EG, Van Urk H, Hop WC, Wittens CH. Endoscopic versus open subfascial division of incompetent perforating veins in the treatment of venous leg ulceration: a randomized trial // J. Vase. Surg. - 2015. - Vol. 26. - P. 1049- 1054. (in Eng).
Tisi P.V., Beverley C., Rees A. Injection sclerotherapy for varicose veins. // Cochrane Database Syst Rev. -2018,- Vol. 18, №4.-CD001732. (in Eng).
Venkatraman P.D., Anand S.С, Dean С., Nettleton R. et al. Pilot study investigating the feasibility of an ulcerspecific quality of life guestionnaire. //Phlebology..- 2018,- Vol.20,№ 1,- P. 14-27. (in Eng).
Zacur H, Kirsner RS. Debridement: rationale and therapeutic options Wounds. // Labropoulos N, Leon M, Nicolaides AN.-2020.- Vol. 14,- P.2E-7E. (in Eng).
