The First International Scientific Teleconference
"Cardiovascular Surgery and Angiology - 2003"
V Knyazhev, M. Marinov*, D. Golemanov
MARTORELLS HYPERTENSIVE LEG ULCER A NEW OPERATIVE TECHNIQUE
Vascular Surgery Clinic, Department of Anatomy, Histology and Embriology*
Varna, Bulgaria
Described are the symptoms, clinical course and treatment methods in 26 patients with the so called hypertonic ulcer, reported firstly by Martorell in 1945.
Our first trials of ulcer excisions, their dermal plastics, selective permanent infusions of vasoprotective drugs and other activities ended with complete failure.
The ultrasound doppler examination close to the edge of the whole ulcer circumference showed in all cases the presence of several or more points of high-amplitude arterial systola with no detection of main peripheral arteries in that area.
The performed in 6 cases histological analysis of the periulcerous tissues confirmed the presence of many pathologically elongated, hypertpophic, thick-walled arterioles, located in the dermo-epidermal stratum.
In all cases /26 patients/ we put thick wab ligatures deeply in the skin around the whole circumference of the ulcer for a period of 15-20 days. The pain decreased in the first several postoperative days. The complete ulcer healing depended on their size but it was achieved in 100 per cent of the cases.
On the background of antihypertensive therapy we didnt register any recurrence for a period of 10 years.
Key words: hypertensive leg ulcer, new operative method
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