TY - JOUR

T1 - Experience in the lower extremities trophic ulcers treatment in patient with combined pathologies: varicose veins and rheumatoid arthritis

AU - Gavrilov, Konstantin

AU - Markina, Veronika

AU - Sevostyanova, Ksenia S.

AU - Shevela, Andrey I.

N1 - Публикация для корректировки.

PY - 2023

Y1 - 2023

N2 - Varicose veins of the lower extremities is one of the most common diseases on Earth and its combination with other diseases is inevitable. The combination of diseases aggravates the course of each other. Rheumatoid arthritis worsens the course of varicose veins with trophic disorders – both independently – an increase in pro-inflammatory factors, a change in microcirculation, deformation of the limb axis with a violation of musculoskeletal function, and treatment of rheumatoid arthritis reduces the immune response of the body reducing the reparative capabilities of the body. Clinical case: a patient with a long course of rheumatoid arthritis and varicose veins. For a long time he used cytostatic drugs with a subsequent transition to hormonal drugs. For about 5 years, he noted the appearance of ulcers on both shins, which took a circular shape, which significantly reduced the quality of life and did not respond to conservative treatment. He repeatedly underwent inpatient treatment with intravenous administration of general restorative and vascular drugs. He was also constantly observed in the polyclinic at the place of residence with the implementation of local treatment of ulcerative surfaces. The patient was successively treated for varicose veins by endovenous laser coagulation of the trunks of large subcutaneous veins. The second stage was performed debridement of the wound surface and skin grafting with a free perforated flap. Between the stages, the appointment of drug therapy according to clinical recommendations. Rheumatoid arthritis and varicose veins aggravate each other, especially trophic manifestations. Treatment of such patients should be carried out by a team of specialists of various profiles together. Step-by-step treatment of such patients with careful preparation for each of them shows excellent results. A special place is occupied by the patients’ commitment to treatment.

AB - Varicose veins of the lower extremities is one of the most common diseases on Earth and its combination with other diseases is inevitable. The combination of diseases aggravates the course of each other. Rheumatoid arthritis worsens the course of varicose veins with trophic disorders – both independently – an increase in pro-inflammatory factors, a change in microcirculation, deformation of the limb axis with a violation of musculoskeletal function, and treatment of rheumatoid arthritis reduces the immune response of the body reducing the reparative capabilities of the body. Clinical case: a patient with a long course of rheumatoid arthritis and varicose veins. For a long time he used cytostatic drugs with a subsequent transition to hormonal drugs. For about 5 years, he noted the appearance of ulcers on both shins, which took a circular shape, which significantly reduced the quality of life and did not respond to conservative treatment. He repeatedly underwent inpatient treatment with intravenous administration of general restorative and vascular drugs. He was also constantly observed in the polyclinic at the place of residence with the implementation of local treatment of ulcerative surfaces. The patient was successively treated for varicose veins by endovenous laser coagulation of the trunks of large subcutaneous veins. The second stage was performed debridement of the wound surface and skin grafting with a free perforated flap. Between the stages, the appointment of drug therapy according to clinical recommendations. Rheumatoid arthritis and varicose veins aggravate each other, especially trophic manifestations. Treatment of such patients should be carried out by a team of specialists of various profiles together. Step-by-step treatment of such patients with careful preparation for each of them shows excellent results. A special place is occupied by the patients’ commitment to treatment.

KW - endovenous laser coagulation

KW - inextensible bandage

KW - rheumatoid arthritis

KW - sponge bandages

KW - varicose veins

KW - venous trophic ulcers

UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-85179650902&origin=inward&txGid=205889eb8219bc47e9fe43c6693fffd5

UR - https://www.elibrary.ru/item.asp?id=54922502

UR - https://www.mendeley.com/catalogue/a023ec79-8704-3dd2-87c9-b59bf054a1e4/

U2 - 10.21518/akh2023-020

DO - 10.21518/akh2023-020

M3 - Article

VL - 20

SP - 217

EP - 222

JO - Ambulatornaya Khirurgiya

JF - Ambulatornaya Khirurgiya

SN - 2782-2591

IS - 2

ER -