Treatment of trophic ulcers: on foot, photos

Overview

Disease trophic ulcer known to man since ancient times, and today has not lost its relevance. As a result of disturbances in the blood circulation system, there is a lack of oxygen supply to the tissues and nutrients. Next - a decrease of venous drainage of the growing nature, increasing the metabolic defect and ulceration. The damage grows, increases in size, becomes infected. The lack of epithelialization of ulcers for six weeks and more - a clear sign of the onset of illness. Place the majority of patients - the leg and foot.

Causes

Venous component is the result of a long-term decompensated venous insufficiency. Most cases of the appearance of trophic ulcers It associated with long flowing varicose and the defeat of the superficial veins, or is it post-traumatic disease, which developed as a result of deep vein thrombosis.

It also should include the causes of artery disease, Frostbite or burns limbs, serious injuries, affecting nerves and trunks. Predisposing factors include overweight and the presence of concomitant diseases (diabetes, chronic dermatitis,

atherosclerosis obliterans, varicose veins, etc.).

Classification

Trophic ulcers are classified on the basis of morphology and extent of lesions etiology portion.

Morphologically distinguished:

• primary.
• secondary. It is a complication of the underlying disease. Chronic trophic ulcers leads to vascular change. Blood cells, being outside the vessel, causing inflammation and thrombosis, leading to the formation of ulcers.

Pathological processes in the limbs develop due to endogenous and exogenous factors.

By area, the spread of plagues are:

• small (0, 5 cm to 4 cm in diameter);
• medium (from 5 to 10 cm);
• large (10 to 20 cm);
• extensive (result from the fusion of several ulcers).

Etiology:

• venous - the latest manifestation of varicose veins, thrombophlebitis, venous congenital angiodysplasia.
• arterial - the result of the progressive ischemia atherosclerosis obliterans, thromboangiitis, postembolic occlusion.
• neurotrophic. The reasons are injuries of the spine or head, nerve trunks and endings, toxic, diabetes, infectious polyneuropathy.

symptoms

The clinical picture of the disease varies depending on the stage of the disease, both in their appearance and on the complaints of patients.

First stage:

• pale skin;
• Local burning sensation;
• swelling of the extremities;
• heaviness in the legs after exercise;
• muscle jerking, preferably at night.

Yazvoobrazuyuschy stage:

the appearance of an open circular or oval ulcers;

visual changes of the skin around the ulcer. Taut, shiny skin ulceration around the disc purplish-bluish hue. Cyanosis okoloranevoy surface is shaped spots with rough edges with a tendency to merge;

at palpation rough skin, the touch - painful;

the patient complained of a burning sensation, itching;

absence of a pulse on peripheral arteries;

reducing the sensitivity of the fingers or toes;

sleep disorders, chronic fatigue syndrome.

Epithelialization period:

• healing in the form of the appearance of the epithelium of healthy pink color;
• epicenter ulcer surface covered with fresh scab;
• general condition of patients improved, normal sleep.

Diagnostics

• Examination of the patient, a thorough history.
• Clinical studies of the blood formula.
• Bacteriological sowings exudate for the selection of the antibiotic.
• Doppler.
• X-ray contrast angiography.
• Laser flowmetry.

Treatment

For the treatment of trophic ulcers used conservative and surgical methods. Operations are appointed by the ineffectiveness of the topical treatment and the threat of complications.

Conservative methods:

• primary ulcer cleansing.
• appointment angioprotectors and antiplatelet agents, which prevent stagnation of blood, improve blood circulation and strengthens the vascular wall.
• antibiotic therapy taking into account the sensitivity of the pathogens.
• Tools to improve the regeneration of wounds. It is produced in the form of ointments, oils, proteolytic powders, solutions, pastes and sprays. The modern pharmaceutical industry has adjusted release of finished pads and dressings, providing absorption exudate while the influence of various substances on the wound surface, which greatly facilitates the care of ulcers.
• symptomatic treatment have specialized professionals, whose goal is to stabilize blood sugar and lipid restorative therapy;
• Physical therapy procedures. A good therapeutic effect was observed in the appointment of ultrasonic cavitation wounds, UFO, hyperbaric oxygen therapy, magneto-and laser therapy;
• Spa treatmentIncluding diet therapy, klimatolechebnye event, baths, physiotherapy, massage, etc.

Surgical intervention:

• Minimally invasive surgery. Surgeons use a variety of techniques to facilitate the patient's condition: mioplasticheskaya fastsioektomiya, fleboektomiya, laser surgery, sclerotherapy to eliminate pathological reflux and others.
• When used aterosklerozirovanii bypass and creation of anastomosis.
• When neurotrophic component resect metatarsophalangeal joint and the metatarsal.
• Transplantation areas of healthy skin.
• Amputation of limbs.

complications

Are in the process of generalization due to depletion of the body's defenses, and concomitant severe pathologies:

• phlegmon the soft tissues;
• erysipelas;
• lymphangitis;
• lymphadenitis;
• sepsis.

prevention

Preventive measures are a set of actions aimed at improving the trophism, vascular status and prevention of stress. you must:

• strict compliance with hygiene standards.
• Comprehensive treatment of the underlying disease as recommended profile physician.
• Using the chosen doctor compression underwear. Wearing a medical stockings, bandages or golf.
• timely correction of venous insufficiency.
• Correction of work, mode of operation and working conditions.
• Avoiding heavy physical, psycho-emotional stress and long stay stationary while sitting or standing.
• Good nutrition. Recommended food rich in vitamins and trace elements restricted in fats and salts.
• Sleeping mode. Sleep should be at least 8 hours. Lower limbs during sleep should raise by 15-20%. It is recommended to use special pillows for your feet.
• Refraining from long trips in the car, trips, long hours of travel.
• Complete cessation of smoking and alcohol consumption above the safe dose.
• Adequate physical training load. Showing gymnastics and swimming.
• Wearing orthopedic leather shoesSuitable size.
• Remediation of any damage to the skin antiseptic and bacteriostatic agents (scratches, blisters, cracks, mycosis).

Forecast

Prediction of trophic ulcers depends on the extent of damage and the time of circulation to the phlebologist for help. When running forms complicated by severe concomitant diseases, poor prognosisUp to amputation of the limb. With timely treatment in a medical institution to profile the doctor and the recommendations can repair ulcers. trophic ulcer It has a high relapse rate.

Found a bug? Select it and press Ctrl + Enter