Comprehensive treatment with the use of gravitational therapy was carried out in 56 patients aged from 19 to 68 years. By the method of serial sampling, patients were grouped into 2 groups I-III stages of lymphedema. The first group of patients with primary lymphedema of the lower extremities - 16, the second group of patients with secondary lymphedema - 40. In the examination and treatment of patients, in combination with known methods, gravitational therapy was used. Clinical improvement of the manifestations of the disease, positive changes in the lymphatic drainage, microcirculation, condition of the soft tissues of the lower extremities, mainly in patients with stages I and II, confirmed by computed tomography, triplex scanning, thermography, ultrasound examination of the inguinal lymph nodes and soft tissues, hydrophilic McClura test and Aldrich. It has been established that the use of gravitational effects in combination with contractions of the gastrocnemius muscles stimulates external and internal factors of lymphatic drainage and increases the effectiveness of complex treatment of patients with lower limb lymphedema. However, the low effectiveness of the method of gravitational therapy in patients with primary lymphedema was noted.

Взаимосвязь анатомических особенностей строения магистральных вен с клиническими проявлениями патологии венозной и костно-суставной систем нижних конечностей mouth -30 (10,2%) patients or doubling -24 (8,2%). Vienna Leonardo was detected in 10 (3,4%) and vienna Giacomini in 23 (7,8%) patients. Patients with C3 and C4 classes CVI nontraumatic strain were detected in 59 feet (68,6%) and 51 (79,6%),1%) and 21 (32,8% 2016; 9: 4: 270-274. The purpose of the study In order to optimize diagnostic and treatment tactics of patients with chronic venous insufficiency (CVI), we evaluated the anatomical features of the main veins and changes in the musculoskeletal system (ODS) of the lower extremities. Materials and methods The study involved 293 patients with CVI and concomitant pathology ODS. Doppler ultrasound was performed with angioscanning and clinical analysis of movements, which included podometrics, goniometer and functional electromyography digital fotoplantography. Results and their discussion It was found that 156 (53,2%) patients have typical anatomy of the venous system. In 147 (50,1%) found the relative failure of the valve of common femoral (OBV), thigh (PkV) or tibial veins. In 23 (7,8%) patients showed a doubling of the superficial femoral vein (PBV) with a total diameter 16,3 ± 2,5 mm. Dilatation of deep vein recorded in 31 (10,6%) patients. PBV transposition was observed in 13 (4,4%) patients. The subcutaneous venous system most frequently detected Y-shaped division of the great saphenous vein (BPV) at the

Introduction. Secondary upper-extremity lymphedema is most commonly caused by lymphadenectomy and radiotherapy (RT) of regional lymph nodes. Lymphatic edema differ in the fact that they lead to fibrotic changes in tissues, as the lymph contains up to 2–4% of protein, which causes a specific histopathological response. Proteins, as well as tissue protein-polysaccharide complexes, undergo transformations leading to pathological collagenization, and then to hyalinization and sclerosis. A vicious circle of pathological processes stemming from biophysical and chemical changes in proteins and polysaccharides with metabolic disorders occurs. Compression therapy is the most important component of the fight against both upper- and lower-extremity edema of various origins at any stage of the disease.The aim is to assess the postoperative stabilization of the upper-extremity edema state due to the patient’s self-bandaging using inelastic bandages and the possibility of personalized adjustment of pressure to be applied at the required level. The article provides indications for the use of an adjustable inelastic compression bandage to stabilize edema, and reviews a clinical example of its postoperative use in a patient with grade 4 secondary right upper-extremity lymphedema. Particular emphasis is placed on the versatility of adjustable inelastic compression bandage and the expediency of its widespread use in clinical practice.Conclusion. Simplicity and ease of use with an option to self-adjust and maintain the stable level of therapeutic pressure throughout the entire period of medical rehabilitation, as well as minimization of doctor’s involvement, allow us to recommend the adjustable inelastic compression bandage for effective use in wide clinical practice.

Introduction. Treatment of thrombophlebitis should be complex and, along with mandatory compression, include both systemic and local use of drugs.Aim. To evaluate the efficacy and safety of the standardized use of the combined drug indomethacin/troxerutin in gel in real clinical practice in the treatment of superficial vein thrombophlebitis.Materials and methods. The study included 71 patients with varicose veins complicated by superficial vein thrombophlebitis. In group I patients (n = 35), topical drugs were not used. In group II patients (n = 36), combined drug indomethacin/troxerutin in gel was used daily. The drug was applied to the skin of the lower extremities three times a day, 4–5 cm of gel. Its total daily amount did not exceed 20 cm of gel. The observation period was 10 days. A dynamic scoring of clinical symptoms was performed using a linear analog scale and thermometry of the skin of the lower extremities.Results. On day 10, patients of the main group showed a statistically significant decrease in thermographic parameters in the area of thrombophlebitis: Tmin – 33.23 ± 0.12 °C, Tmax – 39.86 ± 0.24 °C, Tmean – 40.01 ± 0.16 °C (p ≤ 0.05). When assessing the symptoms of thrombophlebitis using a linear analog scale after 10 days of treatment, there was a general decrease in the number of points in the control group to 16.4 ± 0.12 and in the main group to 12.3 ± 0.16 points (p ≤ 0.05).Conclusion. Combined drug indomethacin/troxerutin in gel is an effective and safe combined drug for the treatment of patients with thrombophlebitis of the superficial veins of the lower extremities.

The article provides the literature overview on various current methods of surgical treatment of patients with limb lymphedema. Despite the fact that the basis of the treatment of this pathology is a complex antiedema therapy, the possibilities of conservative therapeutic measures for lymphedema leave much to be desired and cannot often satisfy either patients or clinicians. The use of surgical methods in the treatment of lymphedema has a long history and has gone from various types of resection to reconstructive interventions. The analysis of current literature data has shown that the choice of the volume and method of surgical correction in lymphedema requires a difficult and individual assessment of the pathological changes developing in the disease, which should be identified only with a comprehensive examination of patients. Operations of lymphovenous anastomosis, transplantation of lymph nodes are considered to be the most effective in the prevention or initial stages of lymphedema. With pronounced manifestations of the disease, optimal results are achieved with a reasonable combination of methods improving lymph drainage and operations reducing the excess volume of the affected limb, thereby provided patients with potentially improved functional outcomes and quality of life. The limitations in improvement despite multimodality treatment are consided to be at the level of satisfactory values. The experience of the most lymphedema professionals has to besuggesteda reasonable balance between basic conservative therapy and surgical treatment. Undoubtedly, the results of evaluating these methods will improve the choice of the optimal method for treating patients with limb lymphedema.