Kolomiiets O. Substantiation of the differential approach to the treatment of chronic venous insufficiency complicated by trophic ulcer

The dissertation is devoted to the problem of surgical treatment of chronic venous insufficiency in the stage of active trophic ulcer. The conducted clinical and experimental study allowed to significantly improve the results of treatment of patients with this pathology, by accelerating the healing of trophic ulcers and improving the quality of life, respectively. According to the tasks, 97 patients with chronic venous insufficiency due to thrombophlebitis and varicose veins of the lower extremities were examined in the Department of Vascular Surgery of Khmelnytsky Regional Hospital for the period 2017-2021. Scientifically supplemented data, based on experimental studies, on the morphological features of trophic ulcers caused by chronic venous stasis, namely confirmed the main effect of pathologically altered venous blood flow from the level of hemomicrocirculatory tract (capillary venules and venules) to varicose veins thrombosis, plasmorrhagia of the walls and paravasal space. For the first time, on the basis of experimental research, it is scientifically proved that prolonged intravenous administration of lidocaine solution initiates diffuse changes of fibroproliferative nature with separate areas of scarring, as well as the formation of proliferative acanthotic strands of epidermis of varying degrees of maturation. For the first time, the presence of strong positive correlations between nuclear-cytoplasmic relations in endotheliocytes, the relative volume of damaged endotheliocytes and the area of the ulcer defect (r = + 0.84 ± 0.03) was scientifically determined by correlation analysis. on accelerating the healing of the ulcer defect.