{"title":"Osteoarthritis: modern possibilities of therapy","authors":"Y. Filatova, M. Ilyin, I. N. Soloviev","doi":"10.21518/1995-1477-2022-19-1-60-67","DOIUrl":"https://doi.org/10.21518/1995-1477-2022-19-1-60-67","url":null,"abstract":"The article discusses the treatment of osteoarthritis (OA). In recent decades, ideas about the pathogenesis of OA have undergone significant changes. If at the dawn of the study OA was presented as a degenerative process associated with age, now that some immunological and genetic aspects of the disease have become known, the idea of the pathogenesis of OA has changed. Currently, there are clinical guidelines developed by professional communities that define approaches to the diagnosis and treatment of patients with OA. In Russia, the Association of Rheumatologists and Orthopedic Traumatologists in 2021 developed clinical guidelines for the management of patients with gonarthrosis and coxarthrosis, but currently no clear consensus has been developed in any of the treatment recommendations regarding the use of nutraceuticals and dietary supplements. While according to published studies of plant and botanical nutraceuticals developed from natural products, promising data on efficacy compared to placebo drugs and their potential for the treatment of patients with OA have been demonstrated. According to a study conducted by N.E. Lane et al., patients with OA regularly use supplements, as well as over-the-counter products in combination with prescription drugs, and the likelihood of using prescription products increases with increasing duration and severity of OA. And currently there is not enough knowledge and information about the possibilities of additional use of nutraceuticals in the treatment of patients. The article discusses the composition of the biologically active additive, which has anti-inflammatory, anti-catabolic and antiproliferative effects and can be considered as an addition to NSAIDs, chondroitin sulfate, glycosamine (sulfate or hydrochloride) and their combinations in OA. Type II collagen peptide, curcumin (curcuminoids 95%), black pepper extract (piperine) and Boswellia pilchata extract in clinical studies have demonstrated efficacy and safety in the treatment of patients with OA. A number of studies have also found a number of pleootropic effects. Effects such as anti-inflammatory, neuroprotective, immunomodulatory, cardioprotective and antitumor effects will be important in patients with comorbidity.","PeriodicalId":398195,"journal":{"name":"Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)","volume":"396 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125396386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Morozov, A. Sergeev, S. Zhukov, N. S. Novikova, M. Belyak
{"title":"Modern markers of inflammatory process in surgical practice","authors":"A. Morozov, A. Sergeev, S. Zhukov, N. S. Novikova, M. Belyak","doi":"10.21518/1995-1477-2022-19-1-147-156","DOIUrl":"https://doi.org/10.21518/1995-1477-2022-19-1-147-156","url":null,"abstract":"Introduction. Currently, one of the important problems in surgery is the search for new markers of the inflammatory process to determine the prognosis of the disease, substantiate the need for surgical intervention and to assess the effectiveness of treatment.Aim. To evaluate the possibilities and prospects of using modern markers of the inflammatory process in the practice of a surgeon.Materials and methods. In the course of the present investigation we analyzed relevant sources of domestic and foreign literature on the topic of application and possibilities of use of modern inflammatory process markers in various fields of medicine. Information was collected from databases of ScienceDirect, Cyberleninka.ru, and PubMed.Results. Acute phase proteins, as markers of inflammation, are valuable tools in the diagnosis, treatment and prognosis of inflammatory diseases, as they are sensitive to systemic inflammation. Important criteria for the use of biomarkers of inflammation are: a low number of false positive results and the possibility of using the marker not only as an indicator of the disease, but also to determine the severity of the patient’s condition. In order to assess the presence of inflammation in clinical conditions, laboratories evaluate the concentrations of various acute phase proteins in plasma. Currently, the most relevant markers of inflammatory processes are: C-reactive protein; haptoglobin; presepsin is also an early indicator of inflammation; fibrinogen; serum amyloid A; a complement system containing key markers of inflammation. Determining them in the surgeon’s practice will allow you to predict the outcome of the disease and evaluate the results of treatment.Conclusion. At the moment, the determination of inflammatory markers helps in predicting the disease, planning treatment tactics, evaluating the effectiveness of therapy after surgery and in earlier diagnosis of severe conditions.","PeriodicalId":398195,"journal":{"name":"Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122996053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Zagriadskiǐ, A. M. Bogomazov, E. B. Golovko, M. V. Abritsova
{"title":"Influence of treatment methods on quality of life of patients with hemorrhoidal disease","authors":"E. Zagriadskiǐ, A. M. Bogomazov, E. B. Golovko, M. V. Abritsova","doi":"10.21518/1995-1477-2022-19-1-68-80","DOIUrl":"https://doi.org/10.21518/1995-1477-2022-19-1-68-80","url":null,"abstract":"Introduction. The effectiveness of the treatment of hemorrhoidal disease is based on the frequency of recurrence of hemorrhoid symptoms, the development of early and late postoperative complications, as well as the degree of patient satisfaction with the results of treatment. However, such an indicator as quality of life, which reflects the health of the patient, is not taken into account.Aim. Obtaining data on the influence of the method and type of treatment on the quality of life of patients suffering from acute or chronic hemorrhoids.Materials and methods. The analysis of the influence of the treatment method on the quality of life of patients suffering from acute or chronic hemorrhoids was carried out. The analysis included 1032 patients with stage I–IV hemorrhoids. The age of the patients was 44.8 ± 13.0 (18–94) years. The study included 509 (49.3%) men and 523 (50.7%) women.Results. Quality of life indicators before treatment in all groups are within the reference values, which is associated with adaptation of patients to the disease. After treatment, quality of life indicators naturally increase. However, in patients after hemorrhoidectomy, regardless of the nature of the technique, quality of life indicators are significantly lower than in patients of groups 1 and 2.Conclusions. Quality of life indicators in all groups before treatment are within the reference values and do not have statistically significant differences in the considered indicators. After the treatment, there is a statistically significant increase in the quality of life indicators in all scales. After hemorrhoidectomy, regardless of the nature of the technique, quality of life indicators are significantly lower than in patients of groups 1 and 2, which is associated with surgical trauma. Since the groups of patients are heterogeneous in terms of the stages of the disease, it can be assumed that for each stage of hemorrhoids, there is a subjective perception of the disease, which can be reflected in the quality of life indicators, which requires additional analysis of the results obtained.","PeriodicalId":398195,"journal":{"name":"Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114493107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Air plethysmography characteristic of the pathological segmental hypervolemia of the calf in patients with CVD clinical classes (CEAP)","authors":"A. B. Sannikov, E. Shaydakov","doi":"10.21518/1995-1477-2022-19-1-124-131","DOIUrl":"https://doi.org/10.21518/1995-1477-2022-19-1-124-131","url":null,"abstract":"Introduction. The involvement of pathological segmental venous hypervolemia of the lower leg in patients with varicose veins in the formation of chronic venous insufficiency (CVI) is an established fact, however, objective criteria for this pathohemodynamic phenomenon have not been definitively determined today.The purpose of the study. Determination by air plethysmography (APG) of the degree of functional disorders in the limb and establishment of significant criteria characterizing pathological segmental hypervolemia of the lower leg in patients with CVD of various clinical classes according to CEAP.Materials and methods. For the period from 2002 to 2019, 380 healthy individuals with no symptoms of chronic venous diseases and 896 patients with CVD were examined with the use of APG, with their distribution in accordance with the CEAR international classification as follows: C0–C1, C2–C3, C4–C6 clinical classes. To assess the intensity of venous blood flow, the following values were calculated: the maximum capacity of the leg veins (Venous Capacity – VC), the volume of their evacuation (Evacuation Volume – EV) for a set time, the maximum venous outflow (Maximum Venous Outflow – MVO), the ratio of these values on both limbs (Venous Capacity Index – VC1, Evacuation Volume Index – EVI, Maximum Venous Outflow Index – MVOI).Results. The most statistically significant and conjugate correlation data were obtained (expectation, mean square deviation, standard error of expectation, median and coefficient of variation) during the analysis in groups according to the characteristic VCI.Discussion. The obtained results allowed us to assert that APG is an informative functional method for diagnosing hemodynamic disorders in patients with lower limb CVD.Conclusion. The established criteria of the venous capacity index will allow in practice to give an objective characterization of the degree of change in hemodynamic disorders in patients with CVD before and after the treatment undertaken.","PeriodicalId":398195,"journal":{"name":"Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131439005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Experience of homeopathic ointment during the non-surgical treatment for acute hemorrhoids in the outpatient settings","authors":"B. M. Belik, A. Kovalev","doi":"10.21518/1995-1477-2022-19-1-98-106","DOIUrl":"https://doi.org/10.21518/1995-1477-2022-19-1-98-106","url":null,"abstract":"Introduction. The use of traditional anti-inflammatory and local anesthetic preparations during the non-surgical treatment of acute hemorrhoids is liable to cause the progression of serious side effects in patients.Purpose of the study. To evaluate the clinical efficacy of homeopathic ointment as the topical preparation in the complex treatment of patients with acute hemorrhoids on the outpatient settings.Materials and methods. The comparative analysis of the results of the non-surgical treatment was conducted and applied to 48 patients with acute hemorrhoids of 1–3 degrees, who were divided into two groups. In 23 patients (control group), traditional non-surgical treatment was conducted without the use of topical preparations. In 25 patients (the main group), traditional preparation therapy was supplemented with local treatment using homeopathic ointment.Results. In the patients of the main group, a faster regression of pain syndrome and other manifestations of the disease (itching, burning and discomfort in the anal canal, perianal edema) was noted in the dynamics of treatment, and higher values of quality of life parameters were recorded than in patients of the control group. In the main group, good and satisfactory treatment results were obtained in 23 (92.0%) patients, unsatisfactory – in 2 (8.0%) patients. In the control group, good and satisfactory treatment results were observed in 18 (78.3%) patients, unsatisfactory results – in 5 (21.7%) patients.Discussion. The maximum therapeutic effect with topical application of ointment was observed in patients with acute hemorrhoids of 2–3 degrees, the disease in which proceeded with a pronounced inflammatory-allergic component.Conclusion. Our results allow us to consider homeopathic ointment as an alternative topical preparation in the non-surgical treatment of acute hemorrhoids in outpatient settings in patients with serious contraindications to the use of traditional topical preparations.","PeriodicalId":398195,"journal":{"name":"Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)","volume":"361 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133270734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Bogachev, K. Lobastov, A. A. Fokin, E. Shaydakov, E. Burleva, A. Krylov, V. Barinov, S. Belentsov, V. Soroka, R. Bredikhin, D. A. Rosukhovski, D. Borsuk, P. G. Gabay
{"title":"About the current situation with regard to the risks and prevention of venous thromboembolic complications after varicose vein surgery","authors":"V. Bogachev, K. Lobastov, A. A. Fokin, E. Shaydakov, E. Burleva, A. Krylov, V. Barinov, S. Belentsov, V. Soroka, R. Bredikhin, D. A. Rosukhovski, D. Borsuk, P. G. Gabay","doi":"10.21518/1995-1477-2022-19-1-157-160","DOIUrl":"https://doi.org/10.21518/1995-1477-2022-19-1-157-160","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":398195,"journal":{"name":"Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126221165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Some clinical and laboratory predictors of structural changes in the biological shunt after femoral-popliteal bypass surgery","authors":"N. Khorev, V. I. Kotov, V. O. Konkova","doi":"10.21518/1995-1477-2022-19-1-44-49","DOIUrl":"https://doi.org/10.21518/1995-1477-2022-19-1-44-49","url":null,"abstract":"Introduction. For revascularization in the absence of autovenous material, epoxy-treated bioprostheses from the bovine internal mammary artery are widely used in the Russian Federation, which are subjected to certain structural deformations.Purpose and objectives. To compare the structural changes of the biological prosthesis and autovenes in the long-term period after surgery and to determine the influence of some clinical and laboratory parameters on this process.Materials and methods. The study included 45 patients with isolated occlusion of the superficial femoral artery (PBA), who underwent blood flow restoration using various types of prostheses. The patients were divided into 2 groups: group 1 (main) – 25 patients who underwent femoral-popliteal proximal bypass surgery with epoxy-treated bioprostheses from the bovine internal mammary artery; group 2 (control) – 20 patients who underwent femoral-popliteal proximal bypass surgery with a reversed autovena.Results and discussion. During the follow – up period from 1 year to 8 years, 28% of bioprostheses underwent expansion, and 20.0% of patients with autovena showed narrowing of the shunt. In the main group, males had better biological graft patency (RR = 0.76 CI (0.3 2; 1.77)), but in the control group, the male sex increased the risk of occlusion (RR = 1.25 CI (0.18; 8.77)). When followed up for 5 years, the relative risk of prosthetic expansion decreased. At the same time, in patients of the control group, which is not characterized by ectasia, we revealed a decrease in the relative risk of stenosis. The clinical factor affecting the expansion of the biological prosthesis was type 2 diabetes mellitus.Conclusions. The characteristic structural changes in the separated period (more than a year) for an autovenous conduit are narrowing, and for a biological prosthesis – expansion with the formation of aneurysms.","PeriodicalId":398195,"journal":{"name":"Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115497197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Сlinical case of treatment of superficial thrombophlebitis (unique in its originality)","authors":"A. B. Sannikov","doi":"10.21518/1995-1477-2022-19-1-29-33","DOIUrl":"https://doi.org/10.21518/1995-1477-2022-19-1-29-33","url":null,"abstract":"Among patients with varicose veins, superficial vein thrombophlebitis occurs in 4–59% of patients. Unfortunately, despite the large number of published official sources with recommendations for the treatment of vein thrombophlebitis in our daily clinical practice, we continue to meet not just with casuistic cases, but because of their absurdity, which are beyond reasonable understanding (the appointment of leeches, c auterization of veins with celandine, alcohol compresses and lotions with dimexide). This clinical case report describes the case of a 65-year-old patient who initially sought medical help from a local therapist due to the appearance of a single seal and hyperemia in the upper third of the lower leg. For two weeks, the patient tried to independently stop the inflammation with alcohol compresses. Due to the lack of a positive effect, the district therapist prescribed antibiotics and warming compresses with combined nonivamide/nicoboxil ointment. Two weeks later, with the progression of inflammation and multiple purulent wounds on the background of necrosis foci throughout the inner surface of the entire lower limb, the patient turned to our medical center. As a result, it took us more than two months to stop the inflammation and heal extensive purulent wounds with secondary tension. Treatment of vein thrombophlebitis in varicose veins has been developed in detail for a long time and in detail. The tactics of using conservative means and operational benefits depend on the localization, prevalence, acute or chronic course of the disease. The purpose of this publication is to focus the attention of specialists of a wide profile on a specific example from practice on the choice of methods of treatment of vein thrombophlebitis.","PeriodicalId":398195,"journal":{"name":"Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127904305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Bogachev, B. Boldin, P. Turkin, M. N. Klyuchevskaya
{"title":"Some features of compression therapy for varicose veins of the lower extremities of clinical class C2 according to CEAP","authors":"V. Bogachev, B. Boldin, P. Turkin, M. N. Klyuchevskaya","doi":"10.21518/1995-1477-2022-19-1-13-18","DOIUrl":"https://doi.org/10.21518/1995-1477-2022-19-1-13-18","url":null,"abstract":"Introduction. The main method of varicose vein disease treatment is surgical intervention. At the same time, there is a rather large group of patients who postpone surgical treatment indefinitely. In this situation, conservative measures come to the fore, the key one among which is compression therapy.Aim. Study of the immediate effect of compression therapy on venous outflow from the lower extremities in patients with varicose veins and the medium-term results of medical knitwear classes 1 and 2.Materials and methods. The study enrolled 64 patients (mean age 28.3 ± 2.2 years, mean BMI 25.3 ± 4.1) with large saphenous vein reflux to the upper third of the tibia. Blood flow return time and pump force were measured while walking without and with zero, class 1, and class 2 compression knitted garments on.Results and discussion. On photoplethysmography return times without and with zero compression were 18.4 ± 2.2 s and 18.9 ± 1.4 s (p = 0.62), tibial venous pump strength was 3.6 ± 0.3% and 3.4 ± 0.2% (p = 0.57). Wearing a class 1 knitwear significantly increased return time and lower leg muscle venous pump strength to 21.6 ± 1.9 sec and 6.2 ± 1.8% (p < 0.001). Grade 2 knitwear increased return blood-flow time and tibia musculo-venous pump strength to 28.2 ± 2.6 sec and 12.3 ± 1.6%, which was significantly higher (p < 0.001). Global quality of life index according to CIVIQ-14 at baseline and follow-up was 44.3 ± 4.6 and 17.8 ± 3.6 points respectively (p < 0.001) in the class 1 group. Compression Class II had a mean value of 45.1 ± 3.9 and 18.1 ± 4.3 (p < 0.001).Conclusion. In summary, the RAL class 2 standard compression knitted fabric shows better immediate correction of lower leg muscle venous pump function in patients with primary varicose veins compared to the class 1 compression knitted fabric. In the mid-term followup there were no differences in the elimination of initial venous specific symptoms and in the improvement of the global quality of life index between class I and class II knitwear.","PeriodicalId":398195,"journal":{"name":"Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126305394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Turkin, A. A. Slesareva, S. V. Rodionov, G. A. Varich, A. Kuzhuget, S. A. Ponomar'
{"title":"Modern technologies of venous ulcers treatment in elderly population","authors":"P. Turkin, A. A. Slesareva, S. V. Rodionov, G. A. Varich, A. Kuzhuget, S. A. Ponomar'","doi":"10.21518/1995-1477-2022-19-1-34-42","DOIUrl":"https://doi.org/10.21518/1995-1477-2022-19-1-34-42","url":null,"abstract":"Venous trophic ulcers take place in the terminal stage of chronic venous insufficiency. The problem of venous trophic disorders is extremely relevant due to the high prevalence among the population. This review considers the comparative characteristics of morbidity data on the example of Germany and the Russian Federation. Particular attention paid to the influence of the course of the disease on patient’s life quality during treatment. The causes of high-cost treatment are reported with approximate calculations for 1 clinical case and total annual costs according to foreign researchers (Australia, Great Britain, USA). The risk factors are discussed in the form of certain concomitant nosologies that significantly aggravate the healing process of ulcers with a brief description of the pathogenesis. The review defines the main goals of the treatment of venous trophic ulcers, as well as separate groups of directions in which it is reasonable to carry out therapeutic measures. Article presents a comparative analysis between the methods of applying compression therapy (elastic bandaging, the use of special stockings) and the influence of the choice on the quality of life of patients. Various methods of topical wound care are described with the obligatory consideration of the stage of the wound process, alternative methods of local treatment are listed (for example, the use of autologous platelet-rich plasma). The efficacy of systemic pharmacotherapy in trophic disorders and the treatment potential of various groups of drugs on the rate of ulcer healing were evaluated. The advantages of using surgical treatment are determined, the main surgical techniques are listed, highlighting the advantages and disadvantages of each. Possible treatment strategies for elderly patients also discussed. The complexity of evaluating the effectiveness of new techniques and an integrated approach to treatment is shown, which in the future will help to correct the direction of finding new ways to solve the problem of venous ulcers in this specific group of patients.","PeriodicalId":398195,"journal":{"name":"Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)","volume":"157 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126019673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}