Амбулаторная хирургия (Nov 2023)
The effect of transdermal combined product on the state of microcirculatory blood flow in patients with chronic venous insufficiency
Abstract
Introduction. Treatment of patients with severe chronic venous insufficiency of the lower extremities is complex and along with compression therapy includes transdural use of drugs. Aim. To study the microcirculatory blood flow of the tissues of the distal segments of the lower limbs in patients with severe chronic venous insufficiency and the possibility of its correction with the use of a combined product for local application.Materials and мethods. The study included 40 patients suffering from varicose vein disease with chronic venous insufficiency of C3-C5 stages according to CEAP. In the main group of patients (n = 30) the transdermal combined product Detragel® was used; patients of the comparison group (n = 10) received only basic compression therapy of functional class II. The basis for the assessment of microcirculation of the lower limbs soft tissues was the analysis of the results of laser doppler flowmetry. Results. At local use of Detragel® in combination with elastic bandage in 91% of observations, there was a statically significant decrease of basal blood flow less than 4.0 pf. units (p < 0.05). The mean basal blood flow was 2.7 ± 0.6 pf. units (1.6–3.9 pf. units, 95% CI), which was consistent with normal values. Statistically significant decrease in veno-arteriolar response to 51.5 ± 10.8% (36.0–68.8%, 95% CI) was recorded in 75% of cases after 14 days of topical treatment, although veno-arteriolar response decreased to normal in only 53% of cases. Conclusion. Correction of microcirculatory disorders in patients with varicose vein disease should include local use of medicine.
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