Ulceras venosas crónicas, tratamiento con eco esclerosis

Abstract

The echosclerosis, in the treatment of ulcers, allows resolving the persistence of chronic ulcers in patients with venous insufficiency. The objective of the present work is to determine the efficacy of the use of echosclerosis, healing times and progression in the healing of ulcers.

Terason 3200 ultrasound, polidocanol sclerosant in concentrations of 2 to 3%, 50/8 needles, elastic bandage and coban were used. 40 patients of both sexes, ages 62 to 78 years (2021-2022) with active chronic venous ulcers (greater than 6 months) with diameters between 2 cm and 7 cm. This is an observational - prospective study. The protocol used includes clinical evaluation, physical examination ; location of varicose gulfs, insufficient perforators, measurement of ulcer diameter and CEAP classification. Excluded from the study are anticoagulated patients, acute phlebitis, arterial and/or combined ulcers, and those with active infected venous ulcers. Guided puncture with sclerosant with foam 1/4, Tessari Method in compromised vein with compressive bandage, control and evaluation of the patient at 3, 7, 15, 30 and 60 days was performed.

In 75%, a decrease in diameter between 1 and 2 cm was observed at 30 days d, in 10% complete closure of the ulcer in the same time and in 15% persistence of the ulcer.- In 90% of these cases, complete closure was achieved at 90 days; in the remaining 10% the process required more time due to greater associated trophic disorders, greater evolutionary data and, in some patients, to the persistence of recanalized perforators.

The results obtained allow us to objectify the efficacy in the treatment of chronic ulcers, mainly in those of larger size and greater trophic involvement. Healing times and progression were on average less than those of other studies (1) with a difference of 2+/- 3 cm at 30 days.

(1) P.F. Lawrence, A. Alktaifi, D. Rigberg, B. DeRubertis, H. Gelabert, J.C. Jimenez.- Endovenous ablation of incompetent perforating veins is effective treatment for recalcitrant venous ulcers.- J Vasc Surg., 54 (2011), pp. 737-742