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Compression serves as an important component for carrying out successful and safe phlebosclerosing treatment. At the same time, the necessity of wearing compression hosiery or bandages is associated with known limitations and objections of patients, especially in a hot season. We comparatively assessed efficacy of usual compression stockings and a short-term pneumatic bandage with cryoelements while carrying out sclerosing treatment of dilated intradermal veins. Our open prospective observational study included a total of fifty 18-to-35-year-old women. After performing standardized sclerotherapy of reticular veins and telangiectasias on the symmetrical portions of the lower limbs, a pneumatic cryocompression bandage with a pressure of 50 mmHg was applied onto one of the limbs for 15 minutes, with a class 2 compression (RAL standard) medical stocking put on the other limb to be worn by the patients at daytime for 10 days. We assessed completeness of obliteration of the target veins, frequency of the development of typical undesirable events (ecchymoses, phlebitides, hyperpigmentation and neovasculogenesis), as well as the composite discomfort score according to an 11-point visual analogue scale. It was determined that using the pneumatic bandage with cryoelements as compared with the traditional compression stockings significantly decreased the frequency of the development of typical undesirable events after phlebosclerosing treatment, such as formation of ecchymoses, phlebitides, hyperpigmentation and neovasculogenesis. Significance of differences was revealed as early as 7 days after sclerotherapy, to be increasing during further dynamic follow up. By convenience for the patients, the use of the short-term pneumatic cryobandage was four times better than wearing the compression stockings. A conclusion was drawn that while carrying out sclerotherapy of reticular veins and telangiectasias short-term pneumatic cryocompression by efficacy and safety was not inferior to the traditional medical stockings (RAL standard) and made it possible to significantly decrease the incidence of the known undesirable events after phlebosclerosing treatment.

The study was aimed at evaluating the degree of the systemic and local inflammatory reaction after sclerotherapy, as well as the effect of micronized purified flavonoid fraction (Detralex) thereupon. The study comprised a total of 60 female patients presenting with reticular veins and telangiectasias (clinical class C1 according to the CEAP classification). The patients were subdivided into two groups, each comprising 30 women. The Study Group patients two weeks prior to the forthcoming sclerotherapy had been taking Detralex prescribed at a daily dose of 1,000 mg whose administration was prolonged by not less than 2 months after the procedure. The Control Group patients received no drug. We determined the systemic and local levels of inflammatory markers, anti-inflammatory cytokines and growth factors: C-reactive protein in a highly sensitive range, histamine, interleukin-1, tumour necrosis factor alpha and vascular endothelial growth factor. Patients in the Study and Control Groups on day 10 after sclerotherapy demonstrated a considerable increase in the levels of anti-inflammatory cytokines and inflammatory markers. At the same time, excess of the baseline levels of the parameters in patients taking Detralex was statistically significantly lower as compared with the Control Group patients: C-reactive protein - 6.0±0.9 mg/l vs 8.3±1.0 mg/l; histamine - 87.0±9.8 µg/l vs 156.9±33.9 µg/l; interleukin-1 - 5.9±0.4 pg/ml vs7.6±0.6 pg/ml; tumour necrosis factor alpha - 5.9±0.9 pg/ml vs 7.5±0.4 pg/ml; vascular endothelial growth factor - 252.3±26.0 pg/ml vs 325.1±47.7 pg/ml. A conclusion was made that microsclerotherapy with the use of low-concentration detergent drugs was accompanied by a local vein-specific inflammatory reaction whose degree may be diminished by means of prescribing micronized purified flavonoid fraction (Detralex) two weeks prior to and during the whole subsequent period of phlebosclerosing treatment in a standard daily dose of 1,000 mg.Цель исследования: оценка выраженности системной и местной воспалительной реакции после склеротерапии, а также влияния на нее микронизированной очищенной флавоноидной фракции (Детралекс). В исследование были включены 60 пациенток с ретикулярными венами и телангиэктазами (клинический класс С1 по СЕАР). Больные были распределены на 2 группы по 30 человек в каждой. В основной группе за 2 недели перед предстоящей склеротерапией назначали Детралекс в суточной дозе 1 000 мг, прием которого пролонгировали не менее чем на 2 месяца после процедуры. В контрольной группе препарат не назначали. Определяли системные и локальные уровни маркеров воспаления, провоспалительных цитокинов и ростовых факторов: С-реактивного белка в высокочувствительном диапазоне, гистамина, интерлейкина-1, фактора некроза опухоли-альфа и сосудистого эндотелиального фактора роста. В основной и контрольной группах на 10 сутки после склеротерапии отмечено значимое повышение уровней провоспалительных цитокинов и маркеров воспаления. Вместе с тем, превышение исходных показателей у больных, получавших Детралекс, было статистически значимо ниже, чем в группе контроля: С-реактивный белок – 6,0±0,9 мг/л vs 8,3±1,0 мг/л; гистамин – 87,0±9,8 мкг/л vs 156,9±33,9 мкг/л; интерлейкин-1 – 5,9±0,4 пг/мл vs 7,6±0,6 пг/мл; фактор некроза опухоли альфа – 5,9±0,9 пг/мл vs 7,5±0,4 пг/мл; сосудистый эндотелиальный фактор роста – 252,3±26,0 пг/мл vs 325,1±47,7 пг/мл. Сделан вывод, что микросклеротерапия с использованием препаратов-детергентов низкой концентрации сопровождается локальной вено-специфической воспалительной реакцией, выраженность которой может быть уменьшена путем назначения микронизированной очищенной флавоноидной фракции (Детралекс) за две недели до и на весь последующий период флебосклерозирующего лечения в стандартной суточной дозе 1 000 мг.

The study was aimed at comparatively assessing the efficacy of treatment for venous trophic ulcers at stages II-III of the wound process using special compression knee-length socks of the ULCER X kit (Sigvaris AG, St. Gallen, Switzerland) and long-stretch bandages Lauma. Compression therapy was included into the programme of outpatient treatment of forty 31-to-74-year-old patients presenting with trophic ulcers (stage II-III of the wound process) with an average area of 5,36±1,1 cm2. The Study Group consisting of 20 patients used compression knitted fabrics in the form of knee-length socks ULCER X and the comparison group (n=20) used long-stretch bandages Lauma.The obtained findings (6 months) demonstrated that using compression therapy exerted a positive effect on the process of healing of venous trophic ulcers, also proving advantages of compression therapy with the knee-length socks ULCER X that create an adequate level of pressure on the crus and maintain it in long-term daily use, reliably accelerating the healing of venous trophic ulcers as compared with elastic long-stretch bandages. The use of long-stretch elastic bandages in treatment of venous trophic ulcers turned out to be not only ineffective but fraught with a possibility of the development of various complications. During 6 months of follow up the patients using the special knee-length socks ULCER X were found to have 80 % of ulcers healed (16 patients), mainly within the first 2 months, whereas using elastic bandages resulted in only 30 % of healing (6 patients) by the end of the study. Along with it, we documented a considerable decrease in the malleolar circumference in the study group patients (from 30,05±0,78 to 28,35±0,86 cm) and in the control group from 31,2±30,35 to 30,25±0,75 cm), accompanied and followed by more than a two-fold increase in quality of life of the patients along all the parameters in the study group and a 1.4-fold increase in the control group patients.