Effectiveness of local treatment of venous trophic ulcers in gerontological patients; Оценка эффективности местного лечения венозных трофических язв у геронтологических пациентов

Objective. To assess the effectiveness of local treatment of venous trophic ulcers in gerontological patients. Material and methods. We analyzed treatment venous trophic ulcers in 4 groups of elderly and senile patients. All patients received conservative therapy. In the 1st group (n-74), local injection of 0.1% polyhexanide-betaine gel throughout 7—10 days was followed by liposomal antioxidant-phospholipid complex «Flamena». In the 2nd group (n-69), immune correction with «Imunofan» was carried out along with local therapy. In the 3rd group (n-69), local treatment was combined with pulsed high-intensity optical irradiation of the wound. In the 4th group (n-69), local treatment was combined with immune correction and pulsed high-intensity optical irradiation. Cytological analysis was performed to estimate effectiveness of treatment. Statistical analysis was performed using nonparametric Friedman and Mann—Whitney tests. Results. The number of leukocytes, lymphocytes and macrophages increased by the 7th day of treatment. Activation of inflammation was more pronounced in groups 2, 3 and 4 (p< 0.0083). By the 15th day, leukocyte count decreased. The number of macrophages and lymphocytes remains high; the number of fibroblasts increases. Cytograms were mainly inflammatory and inflammatory-regenerative. By the 22nd day, cytograms corresponded to regenerative-inflammatory and regenerative types with the lowest number of neutrophils, moderate number of lymphocytes, macrophages and fibroblasts. Conclusion. Complex local treatment of venous trophic ulcers with local immunomodulatory therapy and pulsed high-intensity optical irradiation contributes to conversion of chronic inflammation to acute one with initiation of reparation processes and tissue regeneration. © 2025 Elsevier B.V., All rights reserved.