Morphometric evaluation of features of remodelling of the venous bad of the limbs at experimental trophic ulcer and its correction
The progressive course of diseases of the veins of the lower extremities leads to the development of complications in more than 80% of patients with post-thrombotic disease. Purpose of the work: to study the morphometric features of remodeling of the venous bed of the extremities in experimental trophic ulcer and its correction. A complex of morphological methods was used to examine the veins of the lover limbs of 18 adult male Vietnamese pigs, which were divided into 3 groups. 1 group consisted of 6 intact practically healthy animals, the 2 group – 6 pigs with simulated trophic ulcer, the 3 group – 6 animals with Lidocaine-corrected ulcer. The area of the trophic ulcer was measured. The trophic ulcer was taken together with the surrounding tissues, from which histological micropreparations were made, which determined the diameters of capillary venules, venules, outer and inner diameters of venous vessels, the height of endothelial cells, the diameter of their nuclei, nuclear-cytoplasmic ratios in these cells, volume of damaged endotheliocytes. A correlation analysis was performed between the ulcer area and morphometric parameters. Quantitative values were processed statistically. Strong positive correlations have been established between nuclear-cytoplasmic relation in endothelial cells, the relative volume of damaged endotheliocytes, and the area of the ulcer defect (r=+0,84±0,03), at correction of an ulcer by Lidocaine they weakened a little. It was found that the correction of trophic ulcers with Lidocaine led to a decrease in its area by 25.8%. It is established that the experimental trophic ulcer leads to pronounced remodeling of the venous bed of the lower extremities, which is characterized by significant dilation of venous vessels, venous plethora complicated by hypoxia, atrophic, dystrophic, necrobiotic, infiltrative processes and sclerosis. The use of Lidocaine in experimental trophic ulcer improves the adaptive-compensatory and regenerative processes of the modeled pathology, reduces the relative volume of damaged endothelial cells in the venous vessels of the lower extremity by 18.8% (p<0.001).
 Baibakov, V. M. (2016). Model of morphofunctional changes of testicular drainage systems in the experiment. Pediatric Surgery, 1-2, 43-45.
 Beaussier, M., Delbos, A., Maurice-Szamburski, A., Ecoffey, C., & Mercadal, L. (2018). Perioperative Use of Intravenous Lidocaine. Drugs, 78(12), 1229-1246. doi: 10.1007/s40265-018-0955-x
 Bilyaeva, O. O., Korzhik, N. P., & Mironov, O. N. (2014). The role of enterosorbents in the treatment of complicated varicose veins. Clinical Surgery, 6, 53-55.
 Cuomo, R., D’Aniello, C., Grimaldi, L., Nisi, G., Botteri, G., Zerini, I., & Brandi, C. (2015). EMLA and Lidocaine Spray: A Comparison forSurgical Debridement in Venous Leg Ulcers. Adv. Wound Care (New Rochelle), 1, 4(6), 358-361. doi: 10.1089/wound.2014.0605
 Falko, O. V., Shevchenko, N. A., Prokopyuk, V. Yu., Roenko, A. A., & Prokopyuk, O. S. (2017). Comparative analysis of techniques for modeling trophic ulcers in mice. Surgery News, 25(6), 561-566.
 Finlayson, K. J., Parker, C. N., Miller, C., Gibb, M., Kapp, S., Ogrin, R. … Edwards, H. E. (2018). Predicting the likelihood of venous leg ulcer recurrence: The diagnostic accuracy of a newly developed risk assessment tool. Int. Wound J., 15(5), 686-694. doi: 10.1111/iwj.12911
 Goralsky, L. P., Khomich, V. T., & Konopsky, O. I. (2011). Fundamentals of histological technique and morphofunctional research methods in normal and in pathology. Zhytomyr: Polissya.
 Hnatyuk, M. S., & Weak, O. B. (2016). Morphometric assessment of pulmonary heart chamber remodeling features with different types of blood supply. Achievements of Clinical and Experimental Medicine, 1, 17-20.
 Imbernon-Moya, A., JavierOrtiz-de Frutos, F., Sanjuan-Alvarez, M., Portero-Sanchez, I., Merinero-Palomares, R., & Alcazar, V. (2017). Healing of chronic venous ulcer with topical sevoflurane. Int. Wound J., 14(6), 1323-1326. doi: 10.1111/iwj.12806
 Imbernon-Moya, A., JavierOrtiz-de Frutos, F., Sanjuan-Alvarez, M., Portero-Sanchez, I., Merinero-Palomares, R., & Alcazar, V. (2018). Pain and analgesic drugs in chronic venous ulcers with topical sevoflurane use. J. Vasc. Surg., 68(3), 830-835. doi: 10.1016/j.jvs.2017.11.071
 Ivchenko, G., I., & Medvedev, Yu. I. (2010). Introduction to Mathematical Statistics. Moscow: LKI Publishing House.
 Katorkin, S. E., Melnikov, M. A., Kravtsov, P. F., Zhukov, A. A., Kushnarchuk, M. Yu., & Repin, A. A. (2016). The effectiveness of the use of layer-by-layer dermatolipectomy in the complex treatment of patients with venous trophic ulcers of the lower extremities. Surgery News, 24(3), 255-264.
 Kaufman, H., Gurevich, M., Tamir, E., Keren, E., Lipkin, A., & Hayes, P. (2018). Topical oxygen therapy stimulates healing in difficult, chronic wounds: a tertiary centre experience. J. Wound Care, 27(7), 2, 426-433. doi: 10.12968/jowc.2018.27.7.426.
 Lapach, S. N., Gubenko, A. V., & Babich, P. N. (2001). Statistical methods in biomedical research. Excell. Kiev: Morion.
 Makarov, M. A., Avdeev, S. N., & Chuchalin, A. G. (2012). The role of endothelial dysfunction and arterial stiffness in the pathogenesis of chronic obstructive pulmonary disease. Therapeutic Archive, 3, 74-77.
 Naluzhna, T. V. (2013). Endothelial and diastolic heart dysfunction in patients with coronary heart disease in combination with mitral valve prolapse syndrome. Clinical and Experimental Pathology, 12(3), 119-122.
 Norman, G., Westby, M. J., Stubbs, N., Dumville, J. C. & Cullum, N. (2016). A ‘test and treat’ strategy forelevated wound protease activity forhealing in venous leg ulcers. Cochrane Database Syst. Rev., 15(1), CD011753. doi: 10.1002/14651858
 O’Meara, S., Al-Kurdi, D., Ologun, Y., Ovington, L. G., Martyn-St James, M., & Richardson, R. (2014). Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst. Rev., 10(1), CD003557. doi: 10.1002/14651858.CD003557.pub5
 Ovechkin, A. M., & Becker, A. A. (2017). Intravenous infusion of Lidocaine as a promising component of multimodal analgesia affecting the early postoperative period. Regional Anesthesia and Acute Pain Management, 11(2), 73-83.
 Petri, M., Stoffels, I., Jose, J., Leyh, J., Schulz, A., Dissemond, J. … Klode, J. (2016). Photoacoustic imaging of real-time oxygen changes in chronic leg ulcers aftertopical application of a haemoglobin spray: a pilot study. Wound Care, 25(2), 87, 89-91. doi: 10.12968/jowc.2016.25.2.87
 Raffetto, J. D., Eberhardt, R. T., Dean, S. M., Ligi, D., & Mannello, F. (2016). Pharmacologic treatment to improve venous leg ulcerhealing. Vasc. Surg. Venous Lymphat. Disord., 4(3), 371-374. doi: 10.1016/j.jvsv.2015.10.002
 Reznikov, O. G. (2003). General ethical principles of animal experiments. Endocrinology, 8, 142-145.
 Saveliev, В., Gologorodsky, V., & Kirienko, A. (2001). Phlebology. A guide for physicians ed.: by V.S.Savelyev. M.: Medicine.
 Sopata, M., Kucharzewski, M., & Tomaszewska, E. (2016). Antiseptic with modern wound dressings in the treatment of venous leg ulcers: clinical and microbiological aspects. J. Wound Care, 25(8), 419-426. doi: 10.12968/jowc.2016.25.8.419
 Shutov, Yu. M., Shutova, M. Z., & Kotrekhova, A. S. (2015). Complex local treatment of purulent-necrotic complications of diabetic foot syndrome in a polyclinic. Clinical Medicine, 3, 32-39.
 Tatarchuk, L. V. (2018). Morphofunctional reconstruction of the venous bed of the ileum in postresection portal hypertension. Hospital Surgery, 4, 121-125.
 Thistlethwaite, K. R., Finlayson, K. J., Cooper, P. D., Brown, B., Bennett, M. H., Kay, G. … Edwards, H. E. (2018). The effectiveness of hyperbaric oxygen therapy forhealing chronic venous leg ulcers: A randomized, double-blind, placebo-controlled trial. Wound Repair Rege, 26(4), 324-331. doi: 10.1111/wrr.12657
 Thomas, B., Kurien, J. S., Jose, T., Ulahannan, S. E., & Varghese, S. A. (2017). Topical timolol promotes healing of chronic leg ulcer. J. Vasc. Surg. Venous Lymphat. Disord., 5(6), 844-850. doi: 10.1016/j.jvsv.2017.04.019
 Weller, C D, Richards, C, Turnour, L, Patey, A M., Russell, G. & Team, V. (2020). Barriers and enablers to the use of venous leg ulcers clinical practice guidelines in Australian primary care: A qualitative study using the theoretical domains framework. Int. J. Nurs. Stud. 103. doi: 10.1016/j.ijnurstu.2019.103503
 Westby, M. J., Norman, G., Dumville, J. C., Stubbs, N., Cullum, N. (2016). Protease-modulating matrix treatments forhealing venous leg ulcers. Cochrane Databas. Syst. Rev., 15, 12(12), CD011918. doi: 10.1002/14651858
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