TOTAL OZONE THERAPY OF TROPHIC ULCERS OF LOWER EXTREMITIES IN ELDERLY PATIENTS. S. Gorbunov, L. Gorbunova, Ph. Romashov, V. Dmitriev, V. Isaev. Medical Institute Of Frontier-Guard Service, The Medical Academy, Nizhni Novgorod, Russia.
Trophic ulcers of foot and crus are known to be a common pathology among elderly patients causing frequent loss of working capacity and disability, requiring a long course of treatment and having a tendency to recurrence. The available current methods of treatment do not appear to be sufficient and effective enough. It gives rise to a search of new methods for their treatment. Local complex treatment, aimed a sanatory and stimulation of spontaneous epithelization, seems to be more appropriate for patients of elderly and gerontal age, having a lot of accompanied diseases. Hence, current treatment principles should be based on agents with marked antibacterial properties and simultaneously able to eliminate local hypoxia and regulate oxygen dependent processes. Medical ozone meets all these requirements. Regarding its medical properties, ozone has been used in the complex treatment of 42 patients with long-term trophic ulcers of foot and crus (age range 61-84 years). Complex ozone therapy included local effect of gaseous ozone in plastic sac. Besides, for the first 8-10 days the ulcer was covered with ozone saturated antiseptic dressing. With the signs of marked epithelization, antiseptic dressing were substituted by the ones with ozonated olive oil. Ulcers with pyo-necrotic deposit were covered with ozonated enterosorbents for the first 3-5 days. Along with external treatment in plastic sacs, the surrounding surface of ulcer was subcutaneously injected with ozone/oxygen mixture. With the aim of detoxication, as well as normalization of oxygen-dependent processes and improvement of microcirculation, all the patients received intravenous injections of 250.0 mL ozonated rheopolyglukine, daily. The most efficient was found to be a complex treatment of vulnerosorbtion with press-vacuum external ozone therapy in hard-frame chamber. By the 10 - 12 day of treatment the ulcer surface became sterile, epithelization rate being not more than 4-5 % a day, starting from the third week it reached 11-12 % a day. Only one patient, out of 42, did not have a complete cover of ulcerative defect in skin surface.