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

stages, who were treated in the period 2016-2018. In this group, patients underwent conservative and traditional methods of treatment. In parallel, drug treatment was prescribed, consisting of phlebotonics, NSAIDs, antihistamines and antibacterial drugs. The main group consisted of 64 (52.5%) patients with CVI of the lower extremities, which also included patients in the C6 and C6 r stages, who were diagnosed and treated in the period from 2019 to 2021. The main group of patients underwent EVLC + vacuum + autodermoplasty. The average age of the patients was 51.20.4 years, women prevailed in the gender ratio. To assess the severity of the disease, we used a clinical scale for assessing the severity of venous diseases. Examination of patients included diagnostic methods generally accepted for a surgical hospital; of the special research methods, color duplex scanning of the veins of the lower extremities was used, and, according to indications, X-ray contrast phlebography and bacteriological culture from the area of the trophic ulcer were performed. Given the age groups of patients, if necessary, the list of examinations could include echocardiography, examination of narrow specialists with the appointment of appropriate treatment if comorbidities were detected. We have developed the program “Program for assessing the area of the trophic ulcer”“Wound sizedetector.exe”, which allows the non-contact method to determine the size of the trophic ulcer,observe their decrease in dynamics and conduct detailed monitoring with documentary evidence in the database. The interface of the program is convenient, and ease of use makes it possible to recommend it for use, starting with primary health care. Local treatment of trophic ulcers in the main group consisted of treatment with 0.4% electrolytic aqueous solution (EAS) of sodium hypochlorite in the 1st phase and 0.2% EAS of sodium hypochlorite in the 2 nd phase, followed by the use of vacuum therapy in the 1st phase. III. R esults and D iscussion According to the results of the color duplex scanning, depending on the detected reflux, patients with vertical reflux prevailed, compared with a combination of vertical with horizontal and horizontal reflux, as can be seen from Table 1. Table 1: Distribution of patients according to blood reflux on color duplex scanning of the veins of the lower extremities, n=122 Reflux Main, n=64 Control, n=58 TOTAL Vertical 44 40 84 Vertical+horizontal 17 16 33 Horizontal 3 2 5 TOTAL 64 58 122 For the purpose of additional research, all patients underwent bacteriological culture from a trophic ulcer, as a result of which a variety of gram-positive and gram-negative flora were sown, which gave reason to consider the trophic ulcer identical to the infected one in its microflora. In the control group, we used local treatment (sanitation with 0.3% hydrogen peroxide, proteolytic enzymes (trypsin, chymotrypsin), hydrophilic ointments (levomekol, levosin, dioxysol). Surgical treatment was carried out depending on the type of reflux: in 40 cases (68, 9%) vertical reflux, 16 cases (27.5%) vertical + horizontal reflux and 2 cases (3.6%) horizontal refluxes, performed traditional types of surgical intervention: phlebectomy according to the Babcock technique (38 cases), phlebectomy according to the Babcock technique+ Linton (3 cases), phlebectomy according to the Babcock technique + Cocket (15 cases) and Endolinton (2 cases). The assessment of the ongoing treatment was carried out at 1, 5, 10, 15, 20, 30 after its start. The evaluation criteria were the indicators of the VCSS scale. The pain syndrome did not disappear completely in any patient. Against the background of the ongoing treatment, the duration of the inflammation phase decreased to 5.1%, the proliferation phase to 6.7% and the healing phase to 9.8%. The entire course of treatment in the control group was 8-21 bed-days, and the epithelialization period was 7-18 days. In the control group of patients after the treatment in 10 cases there was a relapse of the trophic ulcer, in the rest of the patients the trophic ulcer was completely cured. The proposed method for the local treatment of trophic ulcers, treatment with 0.4% EAS sodium hypochlorite in the 1st phase and 0.2% EAS sodium hypochlorite in the 2nd phase, followed by the use of vacuum therapy in the 1st phase, made it possible to achieve the expected results. Assessment of the most common subjective symptom, pain, on a scale showed that from the beginning of treatment, when the initial level was 7.2, on the 15 th day of treatment it decreased to 1.1. According to bacteriological culture, the initial level was 7.6, and on the 15 th day after the application of local treatment it decreased to 1.0 (CFU/ml). 34 Year 2022 Global Journal of Medical Research Volume XXII Issue II Version I ( DD ) I © 2022 Global Journals Our Viewpoint about Therapeutic Tactics in Patients with Chronic Venous Insufficiency