[Pathogenesis of trophic ulcers in varicose veins of the lower extremities]

The work generalized the results of examination of 418 patients with primary varicosity (V) complicated by trophic ulcers. On the basis of the study conducted by the authors, a conception of pathogenesis is suggested, the main links of which are microcirculatory disorders in the system of perforating veins of a closed structure, and deficient resolution of fibrin due to diminished local fibrinolytic activity of the plasma. Insufficient fibrin splitting leads to the formation of paravasal collagen cuffs preventing normal exchange between the capillaries and tissues. Impaired nutrition facilitates spasm of arteries and arterioles, whose genesis magnesium deficit contributes to. Activation of collagenolytic peptidases-cathepsins, D, A, B occurs in the ischemic tissues, which leads to destruction of the skin and the formation of ulcers. The disease is attended by disorders of immunity (secondary immunodeficiency), which reduces the reparative processes and thus promotes the development of a chronic process. A complex approach to the treatment of V in the presence of trophic ulcers is suggested.