Surgical Restoration of the Skin in Patients with Trophic Ulcers of Various Origins

  • V. V. Boyko Zaycev Institute of General and Urgent Surgery of the NAMS of Ukraine, Kharkiv, Ukraine
  • A. V. Kravtsov Zaycev Institute of General and Urgent Surgery of the NAMS of Ukraine, Kharkiv, Ukraine
  • Yu. I. Isaev Zaycev Institute of General and Urgent Surgery of the NAMS of Ukraine, Kharkiv, Ukraine
  • Yu. I. Kozin Zaycev Institute of General and Urgent Surgery of the NAMS of Ukraine, Kharkiv, Ukraine
  • T. A. Kurbanov Zaycev Institute of General and Urgent Surgery of the NAMS of Ukraine, Kharkiv, Ukraine
Keywords: trophic ulcers, autodermoplasty, complex treatment

Abstract

A study of the effectiveness of surgical treatment aimed at restoring the skin in 176 patients with trophic ulcers of vascular origin. An algorithm of conservative, local and surgical treatment has been developed, which provides full-fledged replacement of the ulcer defect by performing autodermoplasty operations.
Objective. To improve the results of skin plastic operations in the treatment of trophic ulcers based on the optimization of the staged preparation, the performance of surgical intervention and the postoperative management of the wound defect.
Materials and methods. The operations of skin grafting over the past 5 years have been performed by us in 176 patients with trophic ulcers. The area of the wound defect ranged from 10 cm2 to 1000 cm2. An algorithm of treatment was developed and used in clinical practice, consisting of 8 stages aimed at preparing ulcers, performing skin grafting, postoperative treatment, and post-transplant adaptation of skin flaps.

Results and discussion. In the course of the treatment, general infusion, drug therapy and local treatment were carried out against the background of which excision of pathological granulations, preparation of wounds, skin plasty and postoperative treatment were performed.
A long-lasting positive functional and aesthetic effect was obtained.
Conclusions. An algorithm has been developed for the complex treatment of trophic ulcers, including a skin transplantation operation, the clinical application of which provides a longterm healing of a wound defect and an improvement in the quality of life of patients.

References

  1. Nikitin GD, Kartashev IP, Rak AV, Linnik SA, Averyushkin AV, Kravtsov DV, Deliyev BI. [Plastic surgery of chronic neurotrophic ulcers]. SPb.; 2001. Russian.
  2. Obolensky VN, Rodoman GV, Nikitin VG, Karev MA. [Trophic Ulcers of the Lower Extremities - an Overview of the Problem]. Khirurgiya. 2009;17(25):1647-1662. Russian.
  3. Serra R, Rizzuto A, Rossi A, Perri P, Barbetta A, Abdalla K, et al. Skin grafting for the treatment of chronic leg ulcers - a systematic review in evidence-based medicine. Int Wound J. 2017 Feb;14(1):149-157. https://doi.org/10.1111/iwj.12575
  4. Tretyakov AA, Neverov AN, Petrov SV, Gatiatullin IZ. [Complex treatment of trophic ulcers of the lower extremities and long-term non-healing wounds (literature review)]. Orenburgskiy meditsinskiy vestnik. 2016;4(16):62-68. Russian.
  5. Lipnitskiy YeM. [Treatment of trophic ulcers of the lower extremities]. Moscow; 2010. Russian.
  6. Ryabushko RN, Lyahovskyy VI, Ryabushko NA. [Modern Approaches to Integrated Treatment of Venous Trophic Ulcers of Lower Extremities (review article)]. Visnyk Ukrainskoi medychnoi stomatolohichnoi akademii. 2017;17(3(59)):282-287. Russian.
  7. Kravtsov OV, Kozіn YuІ, Іsaiev YuІ, Tsohoiev AA, inventor; Zaycev Institute of General and Urgent Surgery of National Academy of Medical Science of Ukraine, assignee. [Method for Stimulating Engraftment of Free Autografts in Deep Burns]. Ukrainian patent UA 118139. 2017 July 25. Ukrainian.
Published
2020-12-16
How to Cite
Boyko , V. V., Kravtsov , A. V., Isaev, Y. I., Kozin, Y. I., & Kurbanov, T. A. (2020). Surgical Restoration of the Skin in Patients with Trophic Ulcers of Various Origins. Transplantation and Artificial Organs, (1(01), 41-50. https://doi.org/10.30702/transpaorg/03_20.0112/040-049/44-089
Section
SCIENTIFIC PUBLICATIONS