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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">asurgery</journal-id><journal-title-group><journal-title xml:lang="ru">Амбулаторная хирургия</journal-title><trans-title-group xml:lang="en"><trans-title>Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2712-8741</issn><issn pub-type="epub">2782-2591</issn><publisher><publisher-name>ООО «ГРУППА РЕМЕДИУМ»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/akh2025-054</article-id><article-id custom-type="elpub" pub-id-type="custom">asurgery-585</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ЭСТЕТИЧЕСКАЯ МЕДИЦИНА/КОСМЕТОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>AESTHETIC MEDICINE/COSMETOLOGY</subject></subj-group></article-categories><title-group><article-title>Местное лечение экхимозов после комбинированной чрескожной лазерной коагуляции и склеротерапии</article-title><trans-title-group xml:lang="en"><trans-title>Local treatment of ecchymosis after combined percutaneous laser coagulation and sclerotherapy</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Манджикян</surname><given-names>О. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Manjikian</surname><given-names>H. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Манджикян Овсеп Петросович, сердечно-сосудистый хирург, руководитель флебологической службы, заведующий стационаром кратковременного пребывания по профилю «сердечно-сосудистая хирургия»,</p><p>129327, Москва, ул. Ленская, д. 15</p></bio><bio xml:lang="en"><p>Hovsep P. Manjikian, Cardio-Vascular Surgeon, Head of Vein Clinic, Head of Short-stay Hospital of Cardio-Vascular Surgery,</p><p>15, Lenskaya St., Moscow, 129327</p></bio><email xlink:type="simple">manjikyan@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Городская клиническая больница имени А.К. Ерамишанцева</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Eramishantsev Moscow State Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>25</day><month>11</month><year>2025</year></pub-date><volume>22</volume><issue>2</issue><fpage>93</fpage><lpage>96</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Манджикян О.П., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Манджикян О.П.</copyright-holder><copyright-holder xml:lang="en">Manjikian H.P.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.a-surgeon.ru/jour/article/view/585">https://www.a-surgeon.ru/jour/article/view/585</self-uri><abstract><sec><title>Введение</title><p>Введение. Комбинированная методика чрескожной лазерной коагуляции и склеротерапии имеет широкое распространение благодаря высокой эффективности устранения телеангиэктазий и ретикулярных вен. Однако эта методика может сопровождаться формированием экхимозов различной площади, что снижает комфорт и удовлетворенность пациентов лечением.</p></sec><sec><title>Цель</title><p>Цель. Оценить эффективность применения топического комбинированного флеботропного препарата в форме геля в качестве постпроцедурного лечения экхимозов после комбинированной склеротерапии с чрескожной лазерной коагуляцией ретикулярных вен и телеангиэктазий на нижних конечностях.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. Проведено пилотное парное контролируемое исследование, включавшее 11 пациентов женского пола в возрасте от 29 до 55 лет (средний возраст 42,0 ± 9,8 года). После комбинированной склеротерапии и чрескожной лазерной коагуляции на одну конечность наносился препарат Детрагель® в течение 14 дней, контралатеральная конечность служила контролем. Площадь экхимозов оценивалась на 3-й и 17-й день.</p></sec><sec><title>Результаты</title><p>Результаты. К 17-му дню площадь экхимозов в группе применения топического комбинированного флеботропного препарата в форме геля снизилась с 59,1 ± 11,4 до 12,8 ± 5,4 см², а в контрольной – с 61,1 ± 8,6 до 31,4 ± 7,0 см² (p &lt; 0,001). Удовлетворенность пациентов лечением Детрагелем составила 4,9 балла, врачом – 4,2 балла.</p></sec><sec><title>Выводы</title><p>Выводы. Применение топического комбинированного флеботропного препарата в форме геля (гепарин натрия, фосфолипиды, эсцин) достоверно снижает площадь экхимозов и повышает удовлетворенность пациентов лечением.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. The combined technique of percutaneous laser photocoagulation and sclerotherapy is widely used due to its high effectiveness in eliminating telangiectasias and reticular veins. However, this technique can be accompanied by the formation of ecchymoses of varying sizes, which reduces patient comfort and satisfaction with the treatment.</p></sec><sec><title>Aim</title><p>Aim. To evaluate the effectiveness of a topical combined phlebotropic gel as post-procedural therapy for ecchymoses following combined sclerotherapy with transcutaneous laser coagulation of reticular veins and telangiectasias on the lower limbs.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. A pilot paired controlled study was conducted including 11 female patients aged 29 to 55 years (mean age 42.0 ± 9.8 years). Following combined sclerotherapy and transcutaneous laser coagulation, Detragel® was applied to one lower limb for 14 days, while the contralateral limb served as the control. The area of ecchymoses was assessed on days 3 and 17 after the procedure.</p></sec><sec><title>Results</title><p>Results. By day 17, the area of ecchymosis in the topical combined phlebotropic gel group decreased from 59.1 ± 11.4 to 12.8 ± 5.4 cm², while in the control group it decreased from 61.1 ± 8.6 cm² to 31.4 ± 7.0 cm² (p &lt; 0.001). Patient satisfaction with Detragel® treatment averaged 4.9 points, and physician satisfaction 4.2 points.</p></sec><sec><title>Conclusions</title><p>Conclusions. The use of a topical combined phlebotropic gel containing sodium heparin, essential phospholipids, and escin significantly reduces post-procedural ecchymosis area and enhances patient satisfaction with the treatment results.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>экхимоз</kwd><kwd>склеротерапия</kwd><kwd>чрескожная лазерная коагуляция</kwd><kwd>Nd:YAG 1064 нм</kwd><kwd>CLACS</kwd><kwd>КЛАКС</kwd><kwd>эсцин</kwd><kwd>гепарин</kwd><kwd>эссенциальные фосфолипиды</kwd></kwd-group><kwd-group xml:lang="en"><kwd>ecchymosis</kwd><kwd>sclerotherapy</kwd><kwd>transcutaneous laser coagulation</kwd><kwd>Nd:YAG 1064 nm</kwd><kwd>CLACS</kwd><kwd>escin</kwd><kwd>heparin</kwd><kwd>essential phospholipids</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Богачев ВЮ, Болдин БВ, Туркин ПЮ, Лобанов ВН. 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