Surgical Debridement and Simultaneous Autologous Skin Grafting for Venous Ulcers

Malinin A.A.; Pryadko S.I.; Peskova A.S.; Chomaeva A.A.

doi:https://doi.org/10.17116/flebo202216021130

Malinin A.A.

Bakulev National Medical Research Center for Cardiovascular Surgery

ORCID: 0000-0003-4652-4590

Pryadko S.I.

Peskova A.S.

Bakulev National Medical Research Center of Cardiovascular Surgery

Chomaeva A.A.

Treatment and Rehabilitation Center

Surgical Debridement and Simultaneous Autologous Skin Grafting for Venous Ulcers

Authors:

Malinin A.A., Pryadko S.I., Peskova A.S., Chomaeva A.A.

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Journal: Journal of Venous Disorders. 2022;16(2): 130‑138

DOI: 10.17116/flebo202216021130

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To cite this article:

Malinin AA, Pryadko SI, Peskova AS, Chomaeva AA. Surgical Debridement and Simultaneous Autologous Skin Grafting for Venous Ulcers. Journal of Venous Disorders. 2022;16(2):130‑138. (In Russ.)
https://doi.org/10.17116/flebo202216021130

Подписка 2026 Флебология (Journal of Venous Disorders)

Использование инфографики авторами научных работ

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OBJECTIVE

To evaluate the effectiveness of surgical debridement and simultaneous autologous skin grafting for trophic venous ulcers.

MATERIAL AND METHODS

We observed 70 patients (mean age 56.3±9.2 years) with open trophic venous ulcer of the leg. There were 23 (32.9%) men and 47 (67.1%) women. In case of varicose disease (22 patients), we performed phlebectomy with transection of perforating veins at the first stage. Postoperative complex therapy was carried out until completely epithelization of the ulcer. In case of post-thrombotic disease (48 patients), we performed perforating vein transection, saphenopopliteal bypass and then surgical debridement with simultaneous autologous skin grafting.

RESULTS

In all patients with varicose veins, trophic venous ulcers healed within 64.5±24.3 days after surgery. In patients with post-thrombotic disease, complete or more than 90% engraftment of the skin flap occurred in 36 (75%) cases (within 8.9±2.1 days). Complete epithelialization of the ulcer occurred after 21.3±4.1 days. Ulcer recurrence was observed in 3 (6.3%) patients with post-thrombotic disease. Overall 1-year freedom from trophic ulcer recurrence was 97.4% (p=0.025), 2-year — 94.7% (p=0.036), 3-year — 91.6% (p=0.047).

CONCLUSION

A combined surgical algorithm including elimination of varicose syndrome, reflux through the perforator veins, hemodynamic reconstruction and debridement ensures successful healing of trophic venous ulcers and long-term recurrence-free period.

Keywords:

venous ulcer

debridement

autologous skin grafting

shave-therapy

Authors:

Malinin A.A.

Bakulev National Medical Research Center for Cardiovascular Surgery

ORCID: 0000-0003-4652-4590

Pryadko S.I.

Peskova A.S.

Bakulev National Medical Research Center of Cardiovascular Surgery

Chomaeva A.A.

Treatment and Rehabilitation Center

Received:

28.09.2021

Accepted:

20.01.2022

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References:

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