А.K. FEYSKHANOV¹, A.V. MAKSIMOV^{1, 2}

 ¹Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan, Kazan

² Kazan State Medical Academy – Branch Campus of  RMACPE MH Russia, Kazan

  Contact details:

Feyskhanov A.K. — cardio-vascular surgeon of the Vascular Surgery Department № 1

Address: 138 Orenburgskiy trakt, Kazan, Russian Federation, 420064, tel.: +7-987-296-06-42, e-mail: aygizf@live.com

We have developed a method of complex treatment, rehabilitation and maintenance of therapy of patients with decompensated lymphovenous insufficiency complicated by trophic ulcer and lymphorrhea. Treatment consists of three phases: phase I — sanitation and cleaning of trophic ulcer, elimination of lymphorrhea, reduction of edema, phase II — autodermoplasty, phase III — rehabilitation and supportive therapy. We conducted the successful testing of the method which helped to arrest lymphorrhea, swelling, to heal trophic ulcer, and over the years to maintain the achieved results. Our method of treatment and rehabilitation makes it possible to successfully treat extensive trophic ulcers with abundant lymphorrhea in patients with decompensated lymphovenous insufficiency and to maintain the achieved result.

Key words: lymphovenous insufficiency, trophic ulcer, lymphorrhea, lymphedema.

 (For citation: Feyskhanov А.K., Maksimov A.V. Comprehensive treatment and rehabilitation of decompensated lymphovenous insufficiency patients with a trophic ulcer complicated by lymphorrhea. Practical Medicine. 2019. Vol. 17, № 6 (part 2), P. 94-99)

REFERENCES

1. Kirienko A.I. Bogachev V.Yu. Bogdanets L.I. Treatment of trophic ulcers of venous etiology. Consilium-medicum, 2000, vol. 2, no. 4, pp. 26–32 (in Russ.).
2. Petrov S.V., Bubnova N.A., Rybakova E.V., Fionik O.V., Volkova E.S. Changes in the lymphatic channel of the lower extremities and the possibility of lymphotropic therapy for trophic ulcers of venous etiology. Vestnik khirurgii, 2002, no. 1, pp. 19–22 (in Russ.).
3. Bunke N., Brown K. and Bergan J. Phlebolymphedema: usually unrecognized, often poorly treated. Perspect Vasc Surg Endovasc Ther, 2009, vol. 21, pp. 65–68.
4. Nelson E.A., Hillman A. and Thomas, K. Intermittent pneumatic compression for treating venous leg ulcers. Cochrane Database Syst Rev, 2014, vol. 5, CD001899.
5. Lerman M., Gaebler J.A., Hoy S., Izhakoff J., Gullett L., Niecko T., Karaca-Mandic P., O’Donnell T., Rockson S.G. Health and economic benefits of advanced pneumatic compression devices in patients with phlebolymphedema. J Vasc Surg, 2019, Feb, vol. 69 (2), pp. 571–580. doi: 10.1016/j.jvs.2018.04.028. Epub 2018 Jun 15. PubMed PMID: 29914829.
6. Masuda E.M. and Kistner R.L. Long-term results of venous valve reconstruction: a four- to twenty-one-year follow-up. J Vasc Surg, 1994, vol. 19, pp. 391–403.
7. McGuckin M. and Kerstein M.D. Venous leg ulcers and the family physician. Adv Skin Wound Care, 1998, vol. 11, pp. 344–346.
8. Ma H., O’Donnell T.F. Jr., Rosen N.A. and Iafrati M.D. The real cost of treating venous ulcers in a contemporary vascular practice. J Vasc Surg Venous Lymphat Disord, 2014, vol. 2, pp. 355–361.
9. Makarova V.S., Vyrenkov Yu.E. Kompleksnaya fizicheskaya protivootechnaya terapiya v lechenii limfedem [Complex physical decongestion therapy in the treatment of lymphedema]. Meditsinskaya tekhnologiya. Moscow: ANO “Limfa”, 2014. 120 p.
10. Borisov A.V., Bubnova N.A., Borisova R.P. The value of lymphangion as a structural and functional unit in the new theory of the structure and function of the lymphatic system. Uchenye zapiski SPbGMU imeni I.P. Pavlova, 2009, no. 3 (in Russ.).