OBJECTIVE

To assess the effectiveness of local treatment of venous trophic ulcers in gerontological patients.

MATERIAL AND METHODS

We analyzed treatment venous trophic ulcers in 4 groups of elderly and senile patients. All patients received conservative therapy. In the 1^st group (n-74), local injection of 0.1% polyhexanide-betaine gel throughout 7—10 days was followed by liposomal antioxidant-phospholipid complex «Flamena». In the 2^nd group (n-69), immune correction with «Imunofan» was carried out along with local therapy. In the 3^rd group (n-69), local treatment was combined with pulsed high-intensity optical irradiation of the wound. In the 4^th group (n-69), local treatment was combined with immune correction and pulsed high-intensity optical irradiation. Cytological analysis was performed to estimate effectiveness of treatment. Statistical analysis was performed using nonparametric Friedman and Mann—Whitney tests.

RESULTS

The number of leukocytes, lymphocytes and macrophages increased by the 7^th day of treatment. Activation of inflammation was more pronounced in groups 2, 3 and 4 (p< 0.0083). By the 15^th day, leukocyte count decreased. The number of macrophages and lymphocytes remains high; the number of fibroblasts increases. Cytograms were mainly inflammatory and inflammatory-regenerative. By the 22^nd day, cytograms corresponded to regenerative-inflammatory and regenerative types with the lowest number of neutrophils, moderate number of lymphocytes, macrophages and fibroblasts.

CONCLUSION

Complex local treatment of venous trophic ulcers with local immunomodulatory therapy and pulsed high-intensity optical irradiation contributes to conversion of chronic inflammation to acute one with initiation of reparation processes and tissue regeneration.