Romanyuk T. Trophic Ulcers of Venous Genesis – Surgical Approach.

The thesis is devoted to investigation of the lower limb venous haemodynemics disorders as well as with the healing processes of venous trophic ulcer, to the ground of choice of tactic of surgical treatment of patients with chronic venous insufficiency of lower limb. Haemodynamic and haemocoagulation factors of venous trophic ulcer formation as well as specifics of wound process have been studied. Surgical debridment of the trophic ulcer wound surface followed by the application of the ground pig xenoskin «Xenoderm» substrate mixed with «Biosporin-Biofarma» probiotic was found to be effective in patients with exudating trophic ulcer. At the granulation phase of the wound process (or in persisting trophic ulcer), the consolidating phase should be supplemented by covering a wound surface with cryolyophilised xenodermoimplants. This approach provides to improve the terms of surgical correction on the limb venous system. Haemodynamic studies revealed differing extent of correcting surgical intervention on the limb venous system in patient groups. For group patients with the lower limb I-II degree trophic ulcer (Fistal E.Ya. classification, 2007). At the 1st stage should be shortened stripping of the femoral subcutaneous veins and their inflows. At the 2st stage should be eliminated the pathological refluxat in perforant veins and execute the tibial fasciotomy.