Trophic ulcers: treatment

A trophic ulcer is considered to be a violation of the integrity of the skin mostly on the legs( shin), which is formed in the absence of adequate treatment of varicose veins of the lower extremities.

According to statistics, this complication is waiting for 2 out of 10 patients with varicose dilatation.The trophic ulcer itself is a consequence of the pathology of the veins, so treatment should be exceptionally complex.

Table of contents: General information about trophic ulcers Drug treatment and physiotherapy of trophic ulcer Surgical treatment of trophic ulcer

General information about trophic ulcers

This disease is formed as a result of damage to the integrity of the skin, even if small( scratch, insect bite, trauma).The typical location of the trophic ulcer is the shin, which is caused by frequent stagnation of venous blood in these places, leading to a deterioration of the draining of tissues.

If the wound does not heal for a long time, then the inflammatory process is in it and the dimensions of the lesion increase.Pain syndrome joins when the ulcer extends to the subcutaneous fascia, joints, or bone.It is important to treat such a pathology in a timely manner, as it often causes the tissue to degenerate and develop the cancer process.

It is often said that a trophic ulcer can disappear on its own without treatment.It is true, for the cure at the very beginning of the disease, the patient must always observe a strict bed rest and use compression stockings.But, unfortunately, even after the disappearance of signs of the disease, a relapse is possible, that is, the repeated occurrence of such ulcers.

Note: is important not to moisten the ulcer with water, as this provokes the attachment of a bacterial infection. Do not be afraid of patients with this pathology, because the trophic ulcer is not infectious .

To clean the wound, antiseptic and antibacterial solutions and agents should be used.

If you have a venous stasis in your legs, persistent pains, swelling and trophic ulcers on your lower leg, you should make an appointment with a phlebologist-specialist in veins.

Drug treatment and physiotherapy of trophic ulcer

In addition to treatment of varicose veins, ulceration therapy should be provided.In this case, the following tools are used:

• Antibiotics.They are selected with sensitivity and taken in the form of tablets or injections, and in the form of ointments or sprays( topically).
• Antiseptics.It is best to use the following solutions: Fuzidine, Levomethicin, Miramistin.
• Antimycotic agents - Voriconazole, Fluconazole.
• Phlebotonics.They are shown for the purpose of therapy of the main pathology( Detraleks, Venarus).
• Antiaggregants.These drugs control blood coagulability, normalize microcirculation, prevent stagnation of blood in the legs( Acetylsalicylic acid, Pentoxifylline, Heparin).
• Means for the fastest healing of ulcers.They include Sulfargin and Actovegin, which accelerate regeneration at the tissue level.

Pain in the wound shows painkillers in the form of tablets or sprays, ointments( Parmidin, Ibuprofen, Dimexid, Cefekon, Ketorolac, Emla).

Important: do not forget to cleanse the ulcer regularly, i.e., sanitation. This is done according to the following algorithm:

• Wash the wound with saline( sterile).
• Removal from the ulcer of exudate and necrotic tissues.
• Application of an antibacterial agent.
• Overlap dressing.In the presence of infection, preference is given to special napkins.

Physiotherapy consists of the following procedures:

• laser therapy,
• UV irradiation,
• magnetotherapy,
• Ultrasound cavitation.

All of them contribute to the fastest healing process.

It should be noted that sterile wipes in the treatment of trophic ulcers are indicated in case of suppuration and prolonged non-healing of ulcerative formations.

In particular, they apply:

• Cetuvit E;
• ActiveTex X;
• Protex-TM;
• Biathin;
• Multiferm;
• Koletex.

Such napkins are quite effective, they are usually made of quality knitwear, they have a pronounced antiseptic and antibacterial effect, as they are impregnated with medicines.

Surgical treatment of trophic ulcer

The task of such therapy is correction of venous disorders in the patient's lower extremities, because they are the cause of the appearance and non-healing of trophic ulcers.

If the case is severe, the ulcer is deep, then a layer excision technique is used.After such a procedure, plastic skin is shown( if the lesion area is more than 10 cm2).

In other cases, minimally invasive methods for the treatment of trophic ulcers are justified, which have a lot of advantages, are widely available and maximally non-traumatic.Open surgery with an ulcer can be dangerous, so intravenous techniques are a priority when choosing a technique of treatment in this case.

Methods of surgical treatment of trophic ulcers:

• Catheterization( with long-term healing ulcers).
• Vacuum Therapy.Used to remove purulent contents from the wound, edema, and also to create an environment in the ulcer, which does not penetrate pathological microorganisms.
• "Virtual Amputation".

Treatment with endovenous laser coagulation( ASV38)

The technique is based on the use of laser energy that effectively eliminates varicose veins.This allows eliminating pathological stagnation of blood in the veins and accelerating the healing of ulcers of even a large size.The high temperature of the laser effectively solder the veins from the inside, without damaging the external tissues, than completely excluding it from the bloodstream.

Such intervention does not require extensive incisions, does not leave scarring and scars, as it is performed through small punctures.

Sclerotherapy for trophic ulcers

This is a technique for eliminating varicose veins, as in the case of EVLO, but with it a special preparation is used - sclerosant.The medicine is injected into the diseased veins by means of injections, it fills the vessels, after which they simply "fall off" and turn over into a fibrous cord after a while.

Ultrasound monitoring with this procedure guarantees the accuracy of the drug even in the smallest vein.In elderly people who have a shin ulcer, it is sclerotherapy technology that is used for treatment.

Folk treatment of trophic ulcer

It should be taken into account that such therapy will be effective only in the form of complex treatment, in parallel with other methods and means.In this case, it can not be basic, only additional.Quite effective washing with herbal decoctions, ointments based on plants.Most folk medicine for the treatment of trophic ulcers recommends the use of calendula, chamomile, celandine, string.

At home, such ointments as ichthyol and Vishnevsky are used, they are applied directly to the wound, after cleaning and treatment with vodka.A good effect is noticeable and when applying a bandage with tar per day, after which it is changed to a new one, so do until complete healing.

Betsik Julia, medical reviewer