[Efficacy of dermoplasty and the dermal equivalent in treatment of vast leg ulcers of mixed genesis].

The most frequent causes of leg ulcers (90-95%) are chronic venous insufficiency (45-60%), obliterating atherosclerosis of the lower extremity arteries (10-20%), diabetes mellitus (15-25%) and their combinations (10-15%). The leg ulcers, specified as pyoderma gangrenosum, are the rare and severe pathology, which is very often misdiagnosed. The case history of a 58-year old female patient with vast leg ulcers of the both shanks is analyzed. The leg ulcers were caused by pyoderma gangrenosum and chronic venous insufficiency due to the varicose disease. Complete epithelization of both ulcers was achieved by means of dermoplasty combined using the dermal equivalent against the background of system immunosuppressive therapy.

[Autodermoplasty with split skin grafts in treatment of pyoderma gangrenosum].

Pyoderma gangrenosum (PG) is a rare infectious disease which usually shows itself as painful ulcers on the lower leg. At the present time the autoimmune nature of the disease seems to be most probable. PG is characterized by a phenomenon of pathergy--actuation of the inflammatory process and appearance of ulcers in traumas of the skin. So autodermoplasty of the ulcers in case of PG was "under a ban". In the recent time there appeared publications justifying using methods under conditions of systemic immunosuppressive therapy. Unfortunately the latter is often associated with a great number of side effects which sometimes can result in death.

[Mixed-aetiology extensive ulcers of the crus: postthrombotic disease and gangrenous pyoderma].

Gangrenous pyoderma (GP) is a rare infectious disease typically manifesting itself by utterly painful crural ulcers. Currently, the disease is considered to be most likely of an autoimmune origin. The author presents herein a case report describing key diagnostic and treatment decisions regarding a 30-year-old woman suffering from extensive crural ulcers. Of special interest was the finding that this patient's ultrasonographic duplex scanning showed the signs corresponding to postthrombotic disease. However, conventional treatment of venous trophic ulcers turned out inefficient. The woman was diagnosed as having GP. Topical therapy with corticosteroid drugs (combined with autodermoplasty and compression therapy) made it possible to achieve complete epithelisation of ulcers. Thus, should conventional treatment of venous trophic ulcers result in the patient's failure to respond properly, it is necessary to take into consideration the probability of gangrenous pyoderma.

[Suspension of autogenic thrombocytes in local treatment of ischemic trophic ulcers of lower extremities].

Based on the results of treatment of 10 patients the authors have shown that the application of the suspension of autogenic thrombocytes increased the frequency and rate of epithelization of ulcers.

[Cell therapy in treatment of trophic ulcers of lower extremities].

The aim of the work was to study the effectiveness of using human embryo fibroblast culture in complex treatment of trophic ulcers of venous etiology in 23 patients with trophic ulcers of lower extremities. The cause of the appearance of ulcers was postthrombophlebitic disease in 16 patients and varicose disease in 7 patients. A control group consisted of 25 patients (postthrombophlebitic disease in 18 patients and varicose disease in 7 patients). The human embryo cell culture grown on the wound cover "Foliderm" was used at the stage of epithelization in the main group, while in the control group the modern alginate, collagen, hydrogel, polyurethane and hydrocolloid covers Suprosorb--Suprosorb A, Suprosorb C, Suprosorb G, Suprosorb F and Suprosorb H were used. Healing of the varicose trophic ulcers in the control group was achieved in 86% of patients, of post-thrombophlebitic--in 78% of patients. The average period of healing was 3.6 and 3.9 months respectively. Healing of trophic ulcers in the main group took place in 100% of patients. The average period of healing was 1.5 week for varicose and 3.2 weeks for postthrombophlebitic ulcers. The cell therapy was shown to be a highly effective method in treatment of venous trophic ulcers.

[Endothelial vascular grafts (Experimental research)]. / Endotelizirovannye sosudistye protezy. (Eksperimental'noe issledovanie).

The authors present herein their findings obtained in bench-test and experimental studies, which made it possible to work out an original technology of creating an endothelial covering of the inner surface of vascular grafts made of polytetrafluorethylene. The new technology includes the definite sequential processes which are as follows: 1) creation of vascular endotheliocytes; 2) stimulation of growth and reproduction of endotheliocytes; 3) preparation of the graft, including creation of stable positive potential on its inner surface in order to create optimal conditions for endothelization; 4) graft endothelization itself. In order to assess efficacy of endothelial vascular grafts, we carried out a total of 105 experiments on dogs. The experimental conditions made it possible to comparatively study the standard and endothelialized grafts using them in the position of the aortic abdominal portion, carotid and femoral arteries. The new grafts turned out to possess satisfactory performance properties, which precluded formation of thromboses and hyperplasia of the noeintima, simultaneously providing good implantability.