Experience with Antistax in treatment of venous ulcers of venous etiology

Magomedov M.M., Magomedov A.A., Nurmagomedova P.M.

Dagestan State Medical Academy, Makhachkala, Russia

Aim. Our aim was to improve the results of treatment of trophic disorders in chronic venous insufficiency of the lower limbs by the use in treatment of Lumbar Sympathectomy (LSE), flebotoniks, Antistax.

Methods. Clinical, instrumental: ultrasonic flowmetry, duplex scanning, laser Doppler flowmetry, cytology.

Results. We observed 48 patients with trophic ulcers of venous etiology, including: males, 19 (39.6%), women - 29 (60, 4%). The average age of the patients was 51.8 years. The area of venous ulcers ranged from 0.5 to 59.5 sq cm. The duration of the underlying disease ranged from 6 months to 20 years. The reason for the formation of venous ulcers in cases was 68.8 varicose veins (WB) and the recurrence of varicose veins in 31.2 cases posttromboflebit syndrome (PTS). Surgical treatment of 40 patients were: Isolated phlebectomy performed 19 patients (39.5%), combined with extravazal correction of deep venous valves 2 (4.1%), phlebectomy with over fascial ligation of incompetent perforating veins by Kocket 12 (25.0 %). Phlebectomy with subfascial ligation of perforating the inadequate veins by Linton - 3 patients (6, 2%) was performed. LSE performed in 6 patients (12.5%), of which: 1 - isolation (2, 0) 4 combined with phlebectomy (8, 3%).Group non-operated patients were divided according to the choice of flebotoniks. The criteria for the clinical assessment of treatment effectiveness were the elimination of pain, reduction in limb volume, the rate of ulcer healing. The greatest reduction in pain, as well as the highest rate of ulcer healing observed in the group of patients, combination therapy was supplemented by implementation of LSE. The effectiveness of LSE in these patients was also evaluated in terms of instrumental methods and trunk tissue blood flow, and a review of cytological picture wound fingerprint method M.P. Pokrovsky and M.S. Makarova. According cryptograms wound prints in the study group during the treatment is an intensive decrease in the number of polymorphonuclear neutrophils, macrophages increase, which characterizes the intensity of the biological treatment of wounds. There has also been increase in the number of histiocytes and fibroblasts, reflecting the intense process of formation of granulation tissue. Among non-operated patients the best clinical outcomes, confirmed by cytology, reported in patients treated with Antistax.

Conclusions. 1. The use of LSE in conjunction with reconstructive methods of correction of the venous outflow in the distal limb helps eliminate vasospasm, extending to the normalization of venous collaterals and functions.

2. LSE contributes to the healing of ulcers, as well as more effective relief of pain in patients with trophic venous ulcers.
3. The use of LSE in treatment of these patients significantly improves the intensity of the biological treatment of wounds and the processes of formation of granulation tissue, which is confirmed by cytology.
4. Antistax use of the drug in treatment of venous ulcers leads to a significant reduction of edema, healing of ulcers, also It affirms that the data cytology.