Kalynych S. Biological necrectomy and vacuum - therapy in treatment of decompensated chronic venous insufficiency of the lower limbs.

The paper studied and analyzed the results of a comprehensive examination and surgical treatment of 147 patients with CVI C6 for CEAF, which was operated in the surgical clinic Transcarpathian Regional Clinical Hospital named for Andrew Novak from 2015 to 2018. Depending on the etiology and pathogenesis of disorders of venous hemodynamics and stable mechanism of CVI in 76 (51.7%) of them were diagnosed varicose veins of the lower extremities, 71 (48.3%) patients underwent postromboflebotic syndrome. When varicose trophic ulcers in treatment preference should be given vacuum therapy and radical flebectomy including: SS, short stryping hip and distal sclerotherapy for leg that will eliminate vertical reflux in superficial veins. Ulcers on the background PTFS in treatment should include biological necrectomy (maggot - therapy), along with ultrasonographic scleroobliteration of perforant veins zone trophic ulcers, which eliminates horizontal reflux for perforant veins. Found that cleaning under magot TU-therapy in patients with decompensated course of CVI are much more effective than VAC-therapy. However, all TU larger than 25 cm2 in square were treated by autodermoplasty. In the first group of patients with good and satisfactory results were observed in 75 (98.7%) in the second group – in 63 (88.7%), and poor results in 8 (11.3%) patients. The efficiency with CVI in decompensated varicose origin increased by 16.5 times, with PTFS – 2 times.