asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»10.21518/akh2025-031asurgery-531Research ArticleФЛЕБОЛОГИЯPHLEBOLOGYРоль комплексного применения компрессионного трикотажа в лечении пациентов с хроническими заболеваниями венThe role of the complex application of compression knitwear in the treatment of patients with chronic venous diseasesАнтоновО. Н.AntonovO. N.

Антонов Олег Николаевич, д.м.н., профессор кафедры госпитальной хирургии Института клинической медицины имени Н.В. Склифосовского,

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Oleg N. Antonov, Dr. Sci. (Med.), Professor of the Department of Hospital Surgery, Sklifosovsky Institute of Clinical Medicine,

8, Bldg. 2, Trubetskaya St., Moscow, 119991

antonov_o_n@staff.sechenov.ruКосенковА. Н.KosenkovA. N.

Косенков Александр Николаевич, д.м.н., профессор кафедры госпитальной хирургии Института клинической медицины имени Н.В. Склифосовского,

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Alexandr N. Kosenkov, Dr. Sci. (Med.), Professor of the Department of Hospital Surgery, Sklifosovsky Institute of Clinical Medicine,

8, Bldg. 2, Trubetskaya St., Moscow, 119991

kosenkov_a_n@staff.sechenov.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation20250906202522191100Copyright © Антонов О.Н., Косенков А.Н., 20252025Антонов О.Н., Косенков А.Н.Antonov O.N., Kosenkov A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.a-surgeon.ru/jour/article/view/531

В статье приведен обзор литературы о роли применения компрессионного трикотажа в комплексном лечении хронических заболеваний вен (ХЗВ). Проанализирован патогенез ХЗВ и их осложнений с вытекающей необходимостью соблюдения точно выверенного профиля давления (градуированной компрессии) при выборе компрессионного трикотажа. На основании данных литературы показано, что именно строго подобранный градиент давления гарантирует течение крови к сердцу, а не в обратном направлении или распределение крови по поверхностным венам. Корректная градуированная компрессия снижает венозную гипертензию, улучшает работу скелетно-мышечного насоса, облегчает венозный возврат и улучшает лимфодренаж, оказывая положительные физиологические и биохимические эффекты, затрагивающие венозную, артериальную и лимфатическую системы. Необходимо учитывать тот факт, что у пациентов с выраженным нарушением венозного оттока повышается чувствительность кожи, склонность к атопическим реакциям, раздражениям и различному дискомфорту при ношении компрессионного трикотажа. Это часто приводит к нерегулярному его использованию, что увеличивает сроки лечения. Таким образом, эффективность компрессионной терапии может обеспечить только компрессионный трикотаж высокого качества, подтвержденного клиническими исследованиями, имеющий международные сертификаты соответствия и широкий размерный ряд, позволяющий подбирать компрессионный трикотаж для каждого пациента индивидуально. Приведена внушительная доказательная база, включающая как международные клинические исследования, так и отечественные наблюдения, свидетельствующая о соответствии компрессионного трикотажа mediven® elegance стандартам качества RAL-387. ХЗВ и плоскостопие – связанные между собой состояния. При плоскостопии сильно страдают мышцы голени, которые вынуждены находиться в повышенном напряжении, работая с усиленной нагрузкой. Именно их работа обеспечивает нормальный отток венозной крови. Для снижения риска развития ХВН при плоскостопии рекомендуется использовать ортопедические стельки в сочетании с компрессионным трикотажем, что снижает нагрузку на ноги и способствует замедлению развития варикоза. Совместное использование ортопедических стелек и компрессионного трикотажа уменьшат боль, отеки и тяжесть в ногах, создадут комфорт, повысят уверенность при ходьбе, за счет своей конструкции обеспечат правильное положение стопы, улучшат работу мышц голени и в итоге – венозный отток.

The article provides a review of the literature on the role of compression knitwear in the complex treatment of chronic venous disease (CVD). The pathogenesis of CVD and its complications is analyzed, with the consequent need to follow a precisely calibrated pressure profile (graduated compression) when choosing compression knitwear. Based on the literature data, it has been shown that it is precisely a strictly selected pressure gradient that guarantees the flow of blood to the heart, and not in the opposite direction or the distribution of blood through the superficial veins. Correct graduated compression reduces venous hypertension, improves the functioning of the musculoskeletal pump, facilitates venous return and improves lymphatic drainage, exerting positive physiological and biochemical effects affecting the venous, arterial and lymphatic systems. It is necessary to take into account the fact that patients with a pronounced violation of venous outflow have increased skin sensitivity, a tendency to atopic reactions, irritations and various discomfort when wearing compression knitwear. This often leads to its irregular use, which increases the duration of treatment. Thus, the effectiveness of compression therapy can only be ensured by high-quality compression knitwear, confirmed by clinical studies, having international certificates of conformity and a wide range of sizes, allowing to select compression knitwear for each patient individually. An impressive evidence base is provided, including both international clinical trials and domestic observations, attesting to the compliance of mediven® elegance compression knitwear with RAL-387 quality standards. CVD and flat feet are related conditions. With flat feet, the muscles of the lower leg suffer greatly, which are forced to be under increased stress while working with increased stress. It is their work that ensures the normal outflow of venous blood. To reduce the risk of developing CVD with flat feet, it is recommended to use orthopedic insoles in combination with compression knitwear, which reduces the load on the legs and helps slow down the development of varicose veins. The combined use of orthopedic insoles and compression knitwear will reduce pain, swelling and heaviness in the legs, create comfort, increase confidence when walking, ensure proper foot position due to their design, improve the functioning of the shin muscles and, as a result, venous outflow.

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The authors declare that there are no conflicts of interest present.