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

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.