[Effects of blood refluxes on formation of trophic ulcers in patients with postthrombotic disease].

The results of complex examination of 45 patients with chronic venous insufficiency having class C6 open trophic ulcers by CEAP classification due to postthrombotic disease were analyzed. The localization, intensity and duration of blood refluxes in the venous system of the injured extremity were determined using ultrasonic angioscanning. Highly intensive total reflux of blood in the popliteal and talocrural segments of the lower extremity venous system found in 68.9% of patients has most injuring effects on the microcirculatory bed of patients having postthrombotic disease with recanalization of the profound veins. The developing pathological cross-flow of blood from the musculo-venous pump of the shank into the foot profound veins gives rise to perforator vein incompetence on the foot and shank forming two zones of venous hypertension under and over the ankle-bone. The main factor of the developing trophic ulcers in patients with segmental obliteration (17.8%) and insufficient recanalization of the profound veins (13.3%) was venous hypertension in the distal parts of the injured extremity. Blood refluxes in the shank profound veins were weakly intensive and played a subsidiary role in the development of trophic disorders.