Objective — to analyze the causes and develop methods for the treatment of extensive purulent processes after combined phlebectomy in patients with lower limb varicose veins. Material and methods. The authors reported 3 cases of extensive phlegmon after phlebectomy for the period from 2014 to 2018. It is shown that comprehensive debridement of purulent-inflammatory lesion with application of additional methods including high-energy exposure by the air-plasma flow is essential for effective treatment of this complication. In addition, literature review showed only few observations of severe septic complications after traditional varicose vein surgery. Results. Radical debridement of purulent wounds with wide excision of necrotic subcutaneous tissue and fascia, combination of standard surgical technique and plasma scalpel, as well as subsequent plasmodynamic staged wound repair in a therapeutic mode prevented severe purulent-inflammatory process, stopped systemic inflammatory syndrome and resulted fast wound healing. Conclusion. Active surgical approach combined with air-plasma technology was followed by high-quality correction of extensive suppurative process. Minimally invasive management of varicose disease with improvement of surgical techniques will minimize the likelihood of these complications.