PREOPERATIVE MANAGEMENT AND SURGICAL TACTICS IN LOWER-LIMB VARICOSITY COMPLICATED BY TROPHIC ULCERS

The principles oi preoperative management oi patients with varicosity complicated by trophic ulcers are discussed. The main type of treatment is surgery including subfascial ligation oi the perforating veins of the thigh, leg, and foot+phlebectomy after Troyanov-Trendelenburg-Bebcock-Narath. The author suggests or modifies approaches to the perforating veins. The basis of preoperative management is formed of measures causing a general effect on the organism (lysozymo - and immunoglobulinotherapy, stimulation of regeneration by means of zinc sulphate, transfusion of albumins, etc.), local treatment (cleansing of the ulcer by low-frequency ultrasound, and with immobilized enzymes), and measures for improving microcirculation (magnesium preparations, disaggregants, ultrasound). Complex treatment based on subfascial ligation of perforating veins and removal of varicose superficial veins led to stable healing of ulcers in 98.2 % of patients.