Global Journal of Medical Research, I: Surgeries and Cardiovascular System, Volume 22 Issue 2

Our Viewpoint about Therapeutic Tactics in Patients with Chronic Venous Insufficiency Ravshan Djalilovich Sunnatov α , Sirojbek Zafarovich Tajiev σ & Boboyor Keldiyorovich Keldiyorov ρ Abstract- The research is based on a comparative analysis of the results after treatment of patients with chronic venous insufficiency (CVI) occurred in the lower extremities, patients were admitted to the hospital of the Tashkent Medical Academy and Akfa Medline hospital during the period 2016- 2021. Patients were divided into 2 groups, which includes patients who treated with new treatment method and second group were control for comparison efficiency of the treatment. Conclusions were drawn about the shortcomings of the tactics of managing patients. During the treatment of patients of the main group, android programs were used to measure the area of trophic ulcers, an improved method of sanitation of trophic ulcers and a therapeutic algorithm for managing patients depending on the phase of the process, which led to an increase in the rate of ulcer granulation, and a reduction in the length of stay of patients in the hospital. Keywords: varicose disease of the lower extremities, endovenous laser coagulation, radiofrequency ablation, sclerotherapy, vacuum therapy, trophic ulcer. I. I ntroduction hronic venous insufficiency (CVI) of the lower extremities due to varicose or post- thrombophlebitic disease is one of the most common vascular pathologies in the world [1, 3]. The prevalence of CVI among women is several times higher than among men. According to the epidemiological data, various forms of this disease occur in 26%-38% of women and 10-20% of men of working age [1, 9, 13]. Trophic ulcers are the most common complication of chronic venous insufficiency; it remains an urgent problem in modern medicine [2, 4, 12]. In 15% there are trophic changes in the skin of the lower extremities, 50% of which are complicated by the formation of leg ulcers. Patients with long-term non- healing purulent wounds often stop working early and become disabled [5, 8]. Only a complex effect allows to achieve healing of a peptic ulcer with a long-term remission of the disease. All this indicates the need to search for new and improve existing therapeutic measures, modern surgical techniques and methods of conservative therapy in this area of surgery [7, 10]. Author α : MD, Doctor of Medical Sciences, professor, Head of the Department of Vascular Surgery, Akfa Medline Hospital, Tashkent, Uzbekistan. Author σ : PhD student, MD, Department of Vascular Surgery, Tashkent Medical Academy, Tashkent, Uzbekistan. e-mail : author.uzb@mail.ru Author σ : MD, Vascular Surgeon, Department of Vascular Surgery, Akfa Medline, Tashkent, Uzbekistan. Traditional open intervention or endovascular technologies are usually considered as the method of choice for surgical treatment. According to research data, the use of radiofrequency ablation (RFA), endovenous laser coagulation (EVLC) and echosclerotherapy is preferable. foam-form, the results of which are comparable to those of traditional surgical methods and which allow outpatient treatment, with the patient's ability to work and a satisfactory cosmetic effect [11, 13]. One of the new methods of treatment of wound defects, including in patients with trophic ulcers of venous origin, is vacuum therapy. Vacuum therapy (Vacuum-assisted closure, VAC) is one of the therapies used to improve wound healing [3]. The use of vacuum therapy in the complex treatment of trophic ulcers of venous etiology improves the results of treatment of patients, which is reflected in the acceleration of the course of the wound process, the ability to perform the plastic stage at an earlier date and in the reduction of inpatient treatment [9]. However, despite the large arsenal of surgical interventions, the results of treatment of this category of patients remain insufficiently satisfactory, there are no data on effective methods of local treatment of trophic ulcers and a unified algorithm for managing patients. In connection with the above, we undertook a study aimed at improving the treatment of patients with chronic venous insufficiency complicated by trophic ulcers. Purpose of the study. Improving the results of treatment of chronic venous insufficiency complicated by a trophic ulcer by substantiating the complex use of EVLT with vacuum therapy. II. M aterials and M ethods The study is based on a comparative analysis of the results of treatment of patients with chronic venous insufficiency (CVI) of the lower extremities, who were hospitalized in the departments of vascular surgery and purulent surgery of the Tashkent Medical Academy and in the department of surgery of the private clinic AKFAMedline for the period 2016-2021 Depending on the methods of treatment of CVI of the lower extremities, the patients were divided into 2 groups: control and main. The control group consisted of 58 (47.5%) patients, among whom were patients in the C6 and C6 r C 33 Year 2022 Global Journal of Medical Research Volume XXII Issue II Version I ( D ) I © 2022 Global Journals