Treatment of trophic ulcers of the lower extremities is the complex problem of important social value. Regardless of the etiology of wounds, principles of treatment are to adequately match to topical treatment, which begins with cleansing the wound from fibrin, necrotic masses, abnormal granulation. The research purpose is to develop, to approve a technique of contact controlled destruction of patho-logically changed tissues on a surface of a trophic ulcer and to estimate efficiency of its use. Materials and methods of research. The authors have developed a methodology contact controlled cryodestruction of pathologically changed tissues on the surface of the ulcer with the use of cryo apparatus CRYO-01 "ELAMED". The technique was used in 23 patients in the first phase of wound process to transfer wounds from chronic to acute, acceleration of rejection of necrotic masses. Results and their discussion. During the first bandaging in 2-3 days after removal of a bandage and ma-chining the torn-away impractical tissues were removed easily and without serious consequences, the wound was almost completely cleared of a scab, fibrin and necrotic tissues by 3rd days. That is the II phase of wound process began. Conclusions. Contact controlled cryodestruction of pathologically changed tissues on a surface of a trophic ulcer allows almost without serious consequences, in short terms to transfer a wound to the II phase of wound process and to prepare its surface for different types of skin plasticity.
trophic ulcers, cryodestruction, debridment
1. Andreev A.A., Karpukhin A.G., Frolov R.N., Glukhov A.A. Primenenie gidrolizata kollagena i gidroimpul´snoy sanatsii v lechenii eksperimental´nykh gnoynykh ran. Vestnik eksperimental´noy i klinicheskoy khirurgi. 2014. T. VII, №4. S. 378-387.
2. Bulynin V.I., Glukhov A.A., Moshurov I.P. Lechenie ran. Voronezh: Izdatel´stvo Voronezhskogo gosudarstvennogo universiteta, 1998. 248 s.
3. Burenina I.A. Sovremennye metodiki krioterapii v klinicheskoy praktike. Vestnik sovre-mennoy klinicheskoy meditsiny. 2014. Tom 7. S. 57-61.
4. Vozdushnaya krioterapiya: obshchaya i lokal´naya: sb. st.i posobiy dlya vrachey / pod ed.V.V. Portno-va. M., 2007.
5. Glukhov A.A., Alekseeva N.T., Lobtsov A.V. Kliniko-morfologicheskoe obosnovanie primeneniya gidropressivnoy sanatsii i polyarizovannogo oblucheniya pri lechenii ran myagkikh tkaney v eksperimente. Vestnik eksperimental´noy i klinicheskoy khirurgii. 2010. T. III, № 2. S. 133-145.
6. Lipnitskiy E.M. Lechenie troficheskikh yazv nizhnikh konechnostey. M.: Meditsina, 2001. 160 s.
7. Khramilia V.N. Mestnoe lechenie ran: Uchebnoe posobie dlya vrachey i meditsinskikh sester. M.: «Izdatel´stvo «Prospekt», 2012. 64 s.
8. Chur N.N., Grishin I.N., Chur S.N. Sovremennyy vzglyad na lechenie troficheskikh yazv nizhnikh ko-nechnostey venoznogo geneza. Novosti khirurgii. 2008. T. 16, №2. S. 139-148.
9. Shevchenko Yu.L., Stoyko Yu.M., Gudymovich V.G., Ivanov A.K. Kompleksnyy podkhod v lechenii obshirnykh troficheskikh yazv goleney v mnogoprofil´nom statsionare. Vestnik eksperimental´noy i klinicheskoy khirurgii. 2014. T. VII, №3. S. 221-227.
10. Falanga V. Wound Bed Preparation and the Role of Enzymes: A Case for Multiple Actions of Thera-peutic Agents. Wounds. 2002. V. 14. №2. P. 47-57.
11. Richard P. Usatine, Daniel L. Stulberg, Graham B. Colver Cutaneous Cryosurgery. Principles and Clinical Practice, 2005.
