Trophic ulcers of the lower extremities

The monograph is devoted to a very complicated section of surgery, which in the old days the doctors were called "cross surgeon".
A significant frequency of the disease trophic ulcers, inefficiency of many methods of conservative and not quite satisfactory results of surgical treatment, high disability among these patients give the topic relevant.
Work is multidisciplinary. It reflects the modern view on etiology, pathogenesis of venous ulcers, studied and summarized the reasons many years of failure in the treatment of them. The estimation of various methods of therapy in comparison with the methods developed by the author. Set out new methods of complex surgical intervention in the treatment of trophic ulcers, including vein surgery, fascia tibia, skin plastics etc., Reflect the issues of disability and medical labor expertise. The revised indications for operations of the patients of elderly and senile age.
The monograph is written based on the long experience of the author and opens great prospects in the healing of trophic ulcers. It presents a large number of clinical observations.
The section is intended for surgeons and physicians of other profiles, which have to deal with the treatment of trophic ulcers.
The text is illustrated 35 drawings, 16 tables. The bibliography contains 285 articles of domestic and foreign literature.


General information about trophic ulcers
Some questions of etiology and pathogenesis
Classification and clinical observations
Bone changes
The syndrome of thrombophilia in patients postthrombotic ulcers
Functional tests and methods of diagnosing venous insufficiency
Conservative treatment
Some methods of conservative treatment
Complex treatment
Vacuum therapy
Operative treatment
Some ways of surgical treatment
Issues of comprehensive treatment and pre-treatment
Features of the skin plasty
The possibility of "waste" homology
Surgical treatment of trophic ulcers traumatic aetiology
Surgical treatment of long-term healing granulating burns and burn ulcers
Peculiarities of surgical treatment, x-ray ulcers
Treatment of osteomyelitis ulcers
Treatment of diabetic ulcers
Postoperative recurrence of varicose ulcers
The technique of surgery when varicose veins
Treatment of postthrombotic ulcers
Treatment of trophic ulcers on the soil of obliterating endarteritis and atherosclerosis
Treatment rare trophic ulcers
The possibility of surgical treatment of trophic ulcers in patients of elderly and senile age
Methods of anesthesia
The meaning of work in the development of varicose veins
Clinical-expert classification of trophic ulcers
The issues of medical rehabilitation

The doctrine of trophic ulcers, or hellolove, has a long history, a complex and multi-faceted way. Evidence-based studies of trophic disorders appeared in the beginning of XIX century and was accompanied by the appearance of various theories, which then gave rise to many methods of treatment. However, the poor results of treatment of trophic ulcers encouraged physicians to search for new methods.
With the development and improvement of methods free skin plastics, when to change the islet ways to skin grafting was proposed solid split flap, it has become possible to simultaneously close extensive wound surface. However, the application of such pieces in the zone of trophic disorders are often accompanied by setbacks. The importance of timely engraftment skin flaps have preoperative preparation of ulcers, overall health, the effectiveness of treatment of the underlying disease, complicated by trophic ulcers, and other prevention and care interventions.
Lot of difficulties in the treatment of postthrombotic ulcers with irretrievably lost in the deep veins valves, because until this time next few positive results of surgical treatment are unable even to guarantee a good long-term outcomes. Therefore, the treatment of trophic ulcers is difficult and at the same time, an important challenge to medical science and practice.
Many of trophic ulcers each type represents a single scientific problems, to present and would have taken several similar books. However, from a practical point of view the author managed to systemize and present the basic and the most important sections of diagnostics and treatment of this disease.
The monograph describes the author's proposed operation - fasciale-dermal the compression ratio in the treatment of postthrombotic ulcers - and provides a comparative assessment with other methods of surgical treatment. This operation is of interest, and it can be recommended for a wide application in surgical practice. When postthrombotic syndrome and ulcers allocated syndrome of thrombophilia and describes the prevention of pulmonary embolism. Briefly stated the possibility of using "waste" homology in the skin plasty of trophic ulcers. To determine the function of deep vein described modified (platysmaplasty) sample Perthes disease. The revised indications to surgical treatment of trophic ulcers in patients of elderly and senile age. Noteworthy classification venous ulcers: it is simple structurally and convenient in practical use. Set out the features of operational techniques, issues of medical and social examination and rehabilitation trophic ulcers.
Securities should also recognize the significant volume of the material used for writing monographs, as well as the fact that the author relies not so much on literature data, but rather on careful analysis and synthesis of the studies and objective assessment methods of treatment of trophic ulcers, confirmed long-term clinical observations. There is no doubt that the book M M Sinyavskaya is a useful guide for surgeons in their practical work.
Honored scientist of the RSFSR, doctor of medical Sciences, Professor A. S. Rovnov.