A trophic ulcer is a disease characterized by the formation of defects in the skin or mucous membrane, which occurs after the rejection of necrotic tissue and is characterized by a sluggish course, a low tendency to heal and a tendency to recur.
As a rule, they develop against the background of various diseases, are characterized by a persistent long-term course and are difficult to treat. Recovery directly depends on the course of the underlying disease and the possibility of compensating for the disorders that led to the occurrence of pathology.
Such ulcers do not heal for a long time - more than 3 months. Most often, a trophic ulcer affects the lower extremities, so treatment should begin when the first signs are detected at the initial stage.
Impaired blood supply to the skin area leads to the development of microcirculation disorders, lack of oxygen and nutrients, and gross metabolic disorders in the tissues. The affected area of the skin becomes necrotic and becomes sensitive to any traumatic agents and infection.
The following risk factors can provoke the occurrence of a trophic ulcer on the leg:
When making a diagnosis, the disease that caused the formation is very important, since the treatment tactics for a trophic ulcer on the leg and the prognosis largely depend on the nature of the underlying venous pathology.
The formation of an ulcer on the leg, as a rule, is preceded by a whole complex of objective and subjective symptoms indicating a progressive disorder of venous circulation in the extremities.
Patients note increased swelling and heaviness in the calves, increased frequency of cramps in the calf muscles, especially at night, the appearance of a burning sensation, “heat,” and sometimes itching of the skin of the lower leg. During this period, a network of soft bluish veins of small diameter increases in the lower third of the leg. Violet or purple pigment spots appear on the skin, which, merging, form a large area of hyperpigmentation.
In the initial stage, the trophic ulcer is located superficially, has a moist dark red surface covered with a scab. Subsequently, the ulcer expands and deepens.
Individual ulcers can merge with each other, forming extensive defects. Multiple advanced trophic ulcers in some cases can form a single wound surface along the entire circumference of the leg. The process extends not only in breadth, but also in depth.
Trophic ulcers are very dangerous due to their complications, which are very serious and have poor prospects. If you do not pay attention to trophic ulcers of the extremities in time and do not begin the treatment process, the following unpleasant processes may subsequently develop:
It is imperative that the treatment of trophic ulcers on the legs should be carried out under the supervision of the attending physician without any amateur activity, only in this case can the consequences be minimized.
The main preventive measure to prevent the occurrence of a trophic ulcer is the immediate treatment of primary diseases (circulatory disorders and lymph outflow).
It is necessary not only to use medications internally, but also to apply them externally. Local exposure will help stop pathological processes, treat existing ulcers and prevent subsequent tissue destruction.
A progressive trophic ulcer can over time occupy significant areas of the skin and increase the depth of the necrotic effect. A pyogenic infection that gets inside can provoke the appearance of erysipelas, lymphadenitis, lymphangitis, and septic complications.
In the future, advanced stages of trophic ulcers can develop into gas gangrene, and this becomes a reason for urgent surgical intervention. Long-term non-healing wounds exposed to aggressive substances - salicylic acid, tar - can develop into malignant degeneration - skin cancer.
If there is a trophic ulcer on the leg, one of the main stages of treatment is to identify the cause of the disease. For this purpose, it is necessary to consult with doctors such as a phlebologist, dermatologist, endocrinologist, cardiologist, vascular surgeon or general practitioner.
Late stages of the disease are usually treated in surgical hospitals. However, in addition to identifying and eliminating the cause of a trophic ulcer, it is also necessary not to forget about daily care of the affected area.
How to treat a trophic ulcer of the lower extremities? Several options are used, depending on the severity of the pathological process.
The following drugs are used to treat wounds: Chlorhexidine, Dioxidine, Eplan. At home, you can use a solution of furatsilin or potassium permanganate.
Surgical treatment of trophic ulcers of the lower extremities is indicated for extensive and severe skin lesions.
The operation consists of removing the ulcer with surrounding non-viable tissues, and further closing the ulcerative defect; at the second stage, surgery is performed on the veins.
There are several different surgical techniques:
If the size of the ulcer is less than 10 cm, the wound is closed with its own tissues, tightening the skin by 2-3 mm per day, gradually bringing the edges together and completely closing it in 35–40 days. A scar remains at the site of the wound, which must be protected from any possible injury. If the affected area is more than 10 cm2, skin grafting is used using the patient’s healthy skin.
A course of drug treatment necessarily accompanies any operation. Treatment with medications is divided into several stages, depending on the stage of the pathological process.
At the first stage (wetting ulcer stage), the course of drug therapy includes the following drugs:
Local treatment at this stage is aimed at cleansing the ulcer of dead epithelium and pathogens. It includes the following procedures:
At the next stage, which is characterized by the initial phase of healing and the formation of scars, healing ointments for trophic ulcers - solcoseryl, actevigin, ebermin, etc., as well as antioxidant drugs, for example, tolcoferon, are used in treatment.
Also at this stage, specially developed wound coverings, Swiderm, Geshispon, Algimaf, Algipor, Allevin, etc., are used. Treatment of the ulcerated surface is carried out with curiosin. At the final stages, drug treatment is aimed at eliminating the underlying disease that provoked the appearance of a trophic ulcer.
When starting to treat a trophic ulcer using traditional recipes, you must always consult with your doctor.
At home you can use:
Remember that in the absence of timely and correct therapy, complications such as microbial eczema, erysipelas, periostitis, pyoderma, arthrosis of the ankle joint, etc. may develop. Therefore, you should not use only folk remedies, while neglecting traditional treatment.
To treat this disease, you can also use various ointments, both natural and purchased at the pharmacy. Arnica, comfrey, and indoor geranium ointments effectively heal wounds and have an anti-inflammatory effect.
Vishnevsky ointment is also often used. Of the ointments that can be bought at the pharmacy, dioxykol, levomekol, as well as streptolaven and a number of analogues are especially distinguished.
Trophic ulcers are called violations of the integrity of the skin or mucous membrane, arising due to insufficient blood circulation of epithelial cells and their gradual death. They are located mainly on the legs (in the lower parts), but are also found in other places.
The main difference between such wounds on the legs is long-term healing, which in most cases is impossible without drug intervention. Often ulcers do not heal for more than 60 days, inflammation and swelling of the skin intensify every now and then and require prompt treatment. This material will tell you how to treat trophic ulcers of the lower extremities, their types and characteristics.
Doctors use differentiation of trophic ulcers depending on the root cause of their appearance:
Cause of occurrence: neglected or untreated varicose veins.
Location: lower leg, inner side. Less commonly, venous ulcers form on the back or outside of the lower leg (at the ankle joint).
Symptoms of the onset of the formation of a trophic ulcer due to impaired blood flow in the veins:
If the patient ignores these alarming symptoms and does not treat a trophic ulcer on the leg, the ulcer will begin to spread, affecting deeper layers of skin, and then tendons, muscles and the top layer of bone. This process is accompanied by the release of pus and a repulsive odor.
If treatment is incorrect or delayed, the following complications may develop:
The root cause of this unpleasant phenomenon is obliterating atherosclerosis.
Older people of both sexes are most susceptible to this disease.
Location of wounds: heel, big toe, sole, outer part of the foot.
Symptoms preceding the formation of a wound:
What does an arterial trophic ulcer look like: small size, ragged, sloppy edges, the contents look like pus, the skin around it has a yellowish tint. Often several ulcers appear nearby in a small area of skin.
Cause: diabetes mellitus, resulting in vasoconstriction in the lower extremities (angiopathy). Mechanical damage to dry calluses on the feet can also trigger the development of diabetic ulcers.
Place of occurrence: big toe on the lower limb, feet
The wound looks deep and wide (3-5 cm), the edge is ragged and burgundy in color, and the surrounding skin is pale yellow.
There is a high probability of a bacterial infection that threatens to develop into gangrene in the absence of taking antibacterial drugs.
The root cause of this type of wound is damage to the spinal column or traumatic brain injury.
Location of the neutrophic ulcer: lateral or posterior part of the heel.
A rather rare type of trophic ulcer, it mostly affects females over 45-50 years of age.
Root cause: constant increase in blood pressure (hypertension).
Location on the leg: outer surface of the shins.
The reason for the occurrence of this type of trophic ulcer is a violation of hygiene against the background of a decrease in the overall immunity of the body. As a result, the limbs are affected by eczema, boils or folliculitis. These wounds on the surface of the skin turn into ulcers due to lack of proper treatment.
Place on the lower extremities: lower leg and ankle joint.
Features of pyogenic ulcers:
When examining wounds, in order to correctly select the method of treating a trophic ulcer on the leg, the doctor must prescribe a set of the following measures for examination:
Treatment of trophic ulcers is a lengthy, energy-consuming and individual process. It is impossible to get rid of an ulcer at home: a dermatologist must select the appropriate set of treatment measures based on the type of trophic ulcers, their depth and the presence of additional aggravating factors in the form of associated infections.
The full range of treatment measures includes the following components:
When treating deep types of trophic ulcers, the aim is to cleanse the wound of dead cells, pus and pathogens. There are several ways to surgically clean ulcers:
Effective medication treatment of trophic ulcers on the legs can be carried out separately or as an accompaniment to surgical cleaning of the wound for its speedy healing.
Treatment of trophic ulcers with medications is carried out in several stages:
– At the open wound stage, the following drugs are used:
– At the stage of scar tissue appearance, the following medications are used:
After the beginning of scarring of trophic ulcers, the lion's share of efforts should be made to eliminate the root cause (hypertension, diabetes mellitus, etc.).
To prevent relapse, the following recommendations must be followed:
On earth, over two million people have encountered such a disease as a trophic ulcer. Damage to the feet and legs by a trophic ulcer causes inflammation and severe damage to the basement membrane or epithelium.
The disease destroys the skin, and after they are cured, scars remain. Trophic ulcers on the legs are very difficult to treat. The fact is that when the disease occurs, the nutrition of the cell is disrupted, and the body’s protective functions are noticeably reduced. The difficulty in treating trophic ulcers on the legs is also due to the fact that the body, albeit not significantly, loses its ability to recover.
The root cause of this serious disease is known - it is a violation of the blood supply to the legs. As a result, epithelial cells do not receive the necessary nutrition and, as a result, die. In modern medicine, there are several types of trophic ulcers:
They have the same reasons for their appearance. As a rule, their appearance is facilitated by ischemia of the soft tissues of the lower leg, regular hypothermia of the legs, systematic wearing of tight shoes and injuries to the skin of the legs.
Ulcers appear most often on the big toes, heels and on the foot (its outer side). An arterial or arteriosclerotic ulcer can be recognized by the following signs: these are small suppurating wounds with ragged edges, the skin around which is pale yellow.
As a rule, people of retirement age are susceptible to the disease. The first symptoms indicating the imminent appearance of an ulcer are “intermittent claudication”; its main symptom is rapid fatigue and physical discomfort when walking up stairs.
Constant chills, rapid fatigue, pain in the leg at night and, most importantly, the sore leg always remains cold. With these signs, it is already necessary to consult a doctor and begin treatment. Otherwise, ulcers will appear on the leg, which will only increase.
They most often appear on the lower leg. Ulcers appear when the venous blood flow of the lower limb is disrupted. The reason for their appearance is often a complication of varicose veins.
Alarm bells indicating the appearance of ulcers of this type in a person are as follows:
Venous trophic ulcer
In the lower leg area, the veins enlarge, a venous network appears, and the skin often itches; Over time, the veins “grow” into foci of spots ranging from purple to violet.
Over time, the spots occupy a larger and larger area; The more the disease progresses, the denser the skin becomes, while becoming smooth and acquiring a specific shine. This is what the initial stage of the disease looks like. At the end of it, clamps similar in shape and color to paraffin flakes pop out on the legs.
If you do not start treatment now, otherwise after a short period of time ulcers will form in place of the “flakes”, which will only progress and certainly will not go away on their own.
On the contrary, the disease will progress, the skin, Achilles tendon, calf muscle, and periosteum of the tibia will be affected. The ulcer will continuously fester and, as a result, smell unpleasant.
It is very important to start treatment in a timely manner, and most importantly, correctly. This will avoid the development of serious diseases, including inguinal lymphadenitis, erysipelas, and purulent thrombophlebitis.
In some cases, trophic ulcers with varicose veins lead to elephantiasis of the lower leg and lymphatic enlargement of blood vessels. In medical practice, there have been cases where, with delayed treatment of ulcers, it was not possible to avoid the occurrence of sepsis, accompanied by death.
These ulcers have another name - Martorella. They are rare. The cause of its appearance is constantly elevated blood pressure. As a rule, with such pressure a spasm of the walls of small vessels occurs.
Women who have crossed the 40-year mark of their life are most often at risk of the disease. The first signs of the disease are the appearance of reddish-bluish spots or papules, accompanied by subtle pain.
A characteristic feature of Martorella is that ulcers appear simultaneously on both legs, in the middle of its outer surface. This type of ulcer, unlike others, develops slowly, but is accompanied by severe pain around the clock. There is a huge risk of bacterial contamination.
Diabetic ulcers sometimes lead to amputation
The name of the ulcer speaks for itself. It most often results from a complication of diabetes mellitus. With this type of disease, there is a lack of sensitivity in the lower extremities.
This is the first sign of a diabetic ulcer. There is a simple way to check the sensitivity of your feet. Run your hand down your leg. If the leg is cold to the touch, this is direct evidence of the death of some nerve endings.
Additional signs of the disease are pain at night, and symptoms similar to the development of an arterial ulcer. However, with a diabetic ulcer, there is no “intermittent” claudication syndrome.
Typically, ulcers occur on the thumbs. But at the same time, the wound of a diabetic ulcer is noticeably deeper than the wound of an arterial ulcer. Injuries to calluses on the soles can also lead to this type of ulcer.
The danger of a diabetic ulcer is that it is most often affected by all kinds of infections, which can lead to gangrene and amputation of limbs. The main cause of diabetic ulcers is leg angiopathy in an advanced stage.
The second name for an infectious ulcer is pyogenic. The main reason for their appearance is immunity weakened by purulent eczema, boils, folliculitis and other unpleasant phenomena of a similar nature.
As a rule, diseases of such ulcers are common among people who lead an asocial lifestyle and do not maintain body hygiene. Infectious ulcers can appear as single spots or as clusters on the entire surface of the leg. As a rule, these are oval-shaped wounds of shallow depth. Neurotrophic ulcers. The causes of this type of ulcer are injuries to the spine and head.
They most often appear on the sole from the side of the heel tubercle or on the lateral surface of the heel. These are deep cone-shaped ulcers that corrode tissue down to tendons, muscles and bones.
However, these ulcers are small in diameter. They are “storehouses” of a huge amount of purulent masses with a fetid odor. There is no sensitivity of the skin around the wound.
There is no general systematic approach to the treatment of trophic ulcers in medicine. In each specific case, the approach to the disease and the fight against it, and the reasons for its occurrence, is strictly individual.
The question arises: “Which doctor treats this problem?” You need a phlebologist; it is his consultation that is necessary for a patient suffering from such an illness. It is very important at the initial stage, right, to determine the type of ulcer.
This is achieved through various studies: bacteriological, cytological, histological and other types of disease diagnosis.
Detailed studies allow an accurate diagnosis to be made and appropriate treatment to be prescribed. It can be either medicinal or surgical. Local treatment of trophic ulcers is widely used.
It focuses on clearing pus and necrotic tissue from ulcers. Ointments that promote wound scarring, antiseptic preparations for treating wounds, and agents that relieve inflammation of the epithelium are actively used. Not the least place in the fight against trophic ulcers is occupied by traditional medicine recipes and physiotherapy.
From the initial stage to the ulcer
For trophic wounds, regardless of the cause of their occurrence, it is very important to carry out local treatment at all stages of the disease. There are no special medications for the treatment of this disease.
The most popular for trophic ulcers are ointments with anti-inflammatory, regenerating, antibiotic, analgesic and thrombus-absorbing effects.
Such products are rubbed onto the affected area of the skin at least 2 times a day, after antiseptic treatment of the ulcer site. The ointments most often used to treat the disease are:
Erythromycin - belongs to the group of macrolides, has an antibacterial and slightly anti-inflammatory effect. Helps avoid infection and promotes the treatment of already infected ulcers.
It can be used in patients with allergies to penicillin antibiotics. The ointment has no systemic effect on the body, is non-toxic, practically does not cause side effects and can be used in weakened and elderly patients.
It is usually prescribed only when a purulent or inflammatory lesion has formed as a result of infection by the microorganisms that the active substance affects (staphylococci, brucella, etc.). The course of treatment can be long and last 2-4 months.
Venoruton - the active substance - rutin, protects against the formation of blood clots, prevents inflammation. The gel helps eliminate venous congestion, improve tissue nutrition and oxygenation.
With constant use, the drug prevents thrombus formation and increases the resistance of the vascular wall to negative influences.
Contraindicated in the first 3 months of pregnancy and if you are allergic to the active component of venoruton. Analogues are troxevasin ointment, lyoton gel, troxevenol.
Synthomycin is an ointment with the antibacterial component chloramphenicol. The drug is active against microorganisms resistant to sulfonamides, penicillin and streptomycin.
Has a strong anti-inflammatory effect. Side effects include possible skin irritation (itching, swelling, etc.). If a week after use the condition of the trophic ulcer has not improved, the ointment is replaced with another remedy.
Solcoseryl - available in the form of ointment and gel; the active component of the drug is obtained from the blood of dairy calves. When applied topically, the medicine helps improve metabolism and oxygenation in tissues and accelerate cell restoration processes.
Solcoseryl helps preserve tissue structure, eliminate exudate, accelerate granulation and epithelization. The ointment is used after thoroughly cleaning the wound. When applied, a short-term burning sensation is possible. Side effects include urticaria and dermatitis.
Levomekol - due to ofloxacin, has a wide spectrum of antibacterial effects. The composition also includes several other active components, while methyluracil accelerates recovery, tissue healing and epithelization, increases local immunity, and has an anti-inflammatory effect. Lidocaine helps reduce pain. This multi-component composition helps to achieve simultaneously a regenerating, antimicrobial, local anesthetic and anti-inflammatory effect.
The ointment is applied to sterile napkins, which are applied to a previously cleaned trophic ulcer, once a day. Long-term use of levomekol is not recommended due to the likelihood of absorption of components into the blood.
Betadine is the active ingredient povidone-iodine. The ointment is brown in color, with a slight odor of iodine. It has a bactericidal effect on fungi, bacteria, protozoa and viruses. Studies have shown that with constant use of betadine, a positive effect is noticeable already on the 5th day of use. Contraindicated in case of allergy to iodine, thyroid diseases, chronic renal failure and pregnancy.
Bepanthen - the active substance dexpanthenol, promotes rapid healing of the skin. It also contains chlorhexidine, which has an antiseptic effect. The drug improves trophism and regeneration of ulcer tissue, soothes pain, and protects the wound from infection. The cream does not stick, is easy to apply, and is quickly absorbed. It has virtually no contraindications or side effects.
Tetracycline – has antibacterial, bacteriostatic and antiseptic properties. For trophic ulcers, 3% ointment is used. Apply a thin layer up to 2 times a day.
Like any antibiotic, tetracycline has many local and general side effects. After opening the tube, the drug should not be used for more than 2 months. The ointment can be simply rubbed into the affected area or used as a gauze bandage.
Other ointments and gels can be used in the treatment of trophic ulcers. It is important that the doctor prescribes treatment in accordance with the stage of development, the presence of infection and the clinical course of the disease. You should also be careful about contraindications and possible side effects.
Surgical treatment of ulcers
During surgery, inflammation and dead tissue are removed. Among the surgical methods of combating trophic ulcers, curettage and vacuum therapy are used.
The latter method of treatment allows you to effectively and quickly remove pus from the wound and helps reduce the size and depth of the wound, as well as swelling around it. It helps improve blood circulation.
The risk of complications with this treatment is minimal. In the treatment of poorly healing ulcers, for example, hypertensive or venous ulcers, the catheterization method is widely used.
“Virtual amputation” is an effective way to combat neurotrophic ulcers. With this intervention, resection of the metatarsal bone and metatarsophalangeal joint is carried out without compromising the anatomical integrity of the foot. Surgery concerns only the edges of the ulcer.
After any surgical intervention, it is necessary to undergo a course of medication. Drug treatment can also be used as an independent treatment, rather than as an additional treatment.
It is used in cases of mild to moderate development of peptic ulcer. The treatment procedure takes place in several stages. It all depends on the stage and complexity of the disease.
The sooner the patient contacts the phlebology center, the greater the chance of a speedy recovery and the opportunity to significantly save your budget. A consultation with a phlebologist will cost 1000-2000 rubles, but further treatment, including surgical care, in monetary terms is estimated at approximately 30-50 thousand rubles. This is if we talk about Moscow.
Trophic ulcers are deep purulent-necrotic skin lesions of the extremities that do not heal for more than 1.5 months. The feet and legs are most often affected. The size of the ulcer varies widely: from 1 cm in diameter to a wound surface that occupies the entire surface of the calf.
This pathology is not an independent nosological form. It develops as a complication of certain diseases, has a persistent course and is often curable only by surgery.
Ulcers form against the background of tissue hypoxia, caused by disorders of microcirculation, metabolism and tissue innervation. The skin becomes very vulnerable, and even superficial microdamages lead to the formation of a poorly healing deep defect.
Secondary infection and blood stagnation contribute to the accumulation of toxins in the affected area, which accelerates the development of necrosis and the progression of pathology.
What causes trophic ulcers on the legs? These disorders can develop due to the adverse effects of various causes.
There are external factors that can provoke the formation of an ulcer. These include the following skin damage:
The causes of a trophic ulcer on the leg can be complications of the following diseases:
Experts often state a combination of external and internal factors that led to the formation of a trophic ulcer.
How does a trophic ulcer begin? A person complains of rapid fatigue when walking, a feeling of heaviness in the legs with minor loads, which persists at rest. There is itching of the skin, a burning sensation, crawling in the area of the foot or lower leg, cramps in the calf muscles, especially at night.
Upon examination, the doctor discovers the following initial signs of a trophic ulcer:
With minor trauma, overload, or nervous fatigue, the disease progresses quickly. In the center of the spot, an area of atrophy of the epidermis of a whitish color forms, and a bloody discharge appears.
Symptoms of a trophic ulcer at the height of the disease are as follows:
Ulcers are classified depending on the cause of their formation.
Venous trophic ulcer occurs in 8 out of 10 patients. The cause is stagnation due to impaired venous circulation. A trophic ulcer of the leg most often forms in the lower third on the inner surface of the leg.
The background for the development of pathology in 20% of patients is obliterating diseases of the arteries of the lower extremities. Arterial stenosis leads to ischemia and necrosis of the soft tissues of the legs. Provoking moments are most often injuries or hypothermia of the extremities, the use of uncomfortable shoes.
Features of this type of trophic ulcers: most often occurs in old age, a person experiences difficulty walking up stairs and a feeling of coldness in the leg.
On examination, the leg is cold. Most often, small ulcers with symptoms of suppuration are found in the heel, big toe and on the outer surface of the foot. They have an oval shape, dense edges, and the skin around them acquires a yellow tint.
Trophic foot ulcer is a common complication of diabetes mellitus. Typical localization is the big toe or injured corns in the sole area. Develops in diabetic angiopathy against the background of sharp fluctuations in blood glucose levels.
Characteristic signs: decreased sensitivity in the legs, extinction of tendon reflexes, rapid increase in size of the defect, tendency to develop necrosis, resistance to therapy.
When the central nervous system is affected, the ulcers are located in the heels and soles.
Features of neurotrophic ulcers: small size and significant depth of wounds (down to the bone), abundant purulent discharge with an unpleasant odor in the absence of pain.
They are rare, usually in elderly women against the background of long-term arterial hypertension.
They are characterized by slow formation, and on both legs at once, severe pain syndrome, and a high frequency of purulent complications.
They form on the legs with advanced skin diseases against the background of unsanitary conditions and the accumulation of secondary purulent infection. Features: semicircular shape, small size and depth.
Trophic ulcers with varicose veins are treated by phlebologists and vascular surgeons. Patients with ulcerative skin defects of any etiology are subject to mandatory hospitalization, since effective treatment of trophic ulcers is possible only in an inpatient setting. Complex therapy and dynamic observation are required.
It is permissible to treat a trophic ulcer at home only at the earliest stage.
A trophic ulcer on the leg is accompanied by specific complaints and has a characteristic appearance upon examination. The main task of specialists is to find out the cause of the disease. Only by establishing the etiology of the ulcerative lesion can adequate therapy be prescribed.
The following diagnostic measures are carried out:
The main directions of therapy are the impact on the underlying disease, the fight against secondary infection, and the stimulation of healing of the ulcerative surface.
Treatment of trophic ulcers depends on the following factors:
How to cure a trophic ulcer? Therapy is extremely complex, complex and lengthy. It is more often regarded as preparation for surgery, since conservative methods are not very effective.
If surgery is contraindicated for a patient for some reason, the goal of therapy is to prevent the skin defect from enlarging and deepening.
In a hospital, a patient with a trophic ulcer is provided with bed rest; the affected limb should be in an elevated position to improve blood and lymph circulation.
A universal cure for trophic ulcers, equally effective for all types of disease, has not been developed. Treatment of trophic ulcers on the leg includes taking drugs of various pharmacological groups.
How to treat trophic ulcers with varicose veins? Experts prescribe complex therapy, the purpose of which is to stop inflammation and tissue necrosis and stimulate healing processes.
Medicines from the following groups are used:
The same drugs in different combinations are used in the treatment of trophic ulcers of any etiology.
During the regeneration period, antioxidant, metabolic and immunostimulating therapy is prescribed - injections of Mexidol, Actovegin, ascorbic acid, B vitamins.
Physiotherapy is used to heal trophic ulcers. UHF is used to enhance the anti-inflammatory effects of drugs, electrophoresis with solutions of wound-healing, anti-inflammatory and vascular drugs. Laser treatment is used to reduce pain and inflammation.
During the regeneration and postoperative period, ultraviolet irradiation, ozone therapy, mud therapy, hyperbaric oxygenation, and plasmapheresis are recommended.
Treatment of trophic ulcers of the lower extremities complements proper nutrition. To avoid increasing swelling in the legs, a person should eat more vegetables and fruits, control the amount of fluid consumed, and exclude salty, spicy, pickled foods. With diabetes, patients eat in accordance with the recommendations of the endocrinologist and regularly monitor blood glucose levels.
To cleanse the wound of pus and dead tissue, it is treated with disinfectants.
The following antiseptics are used:
How to treat trophic ulcers on the legs after cleansing them of pus? For healing and accelerated scarring of skin defects, medicinal ointments are used: Solcoseryl, Ebermin, Actovegin. It is effective to use special dressings and sponges with antibacterial, antisecretory and wound-healing effects (Allevin, Algipor, Geshispon).
It is mandatory to use an elastic bandage, which is replaced as necessary several times a day. It not only protects the affected area from secondary infection and injury, but also helps reduce swelling.
A trophic ulcer on the leg can be completely cured through surgery. In order for the operation to be successful, it is necessary to competently prepare the patient for the upcoming intervention, achieve improved well-being, stabilize the general condition and begin healing of the wound surface.
The following methods have been developed in angiosurgery:
If there is a large and deep ulcer, a skin flap is transplanted.
The question of the possibility of outpatient treatment of trophic ulcers is decided only by the treating specialist. With a short duration of the disease, small single ulcers that are at the stage of regeneration, the patient can use folk recipes as a supplement to the main therapy.
How to treat a trophic ulcer at home? Clean the wound surface from any remaining pus, as it slows down healing. For this purpose, decoctions of chamomile, celandine, string, and calendula are used.
After washing the ulcer, with the permission of the doctor, apply pharmaceutical ointments that help relieve inflammation and healing, including Vishnevsky ointment and ichthyol ointment.
You can treat the ulcerative defect with golden mustache juice, make a bandage with an ointment prepared on the basis of propolis, comfrey, and arnica. Apply compresses with powdered leaves of tartar, golden mustache, willow or oak bark, which can be left overnight.
You cannot rely only on traditional medicine; refusal of comprehensive hospital treatment can lead to life-threatening consequences.
In advanced cases and in the absence of active treatment, a number of dangerous complications appear:
Ulcers are dangerous due to rapid progression in severe cases of the underlying disease. At the same time, they not only increase in size, but also become numerous and can merge into a large wound surface.
This pathology is also distinguished by the following features:
The main rule is to consult a doctor in a timely manner if health problems arise. After surgery, to avoid relapses, it is important to adhere to the following recommendations:
Ulcers form as severe complications of advanced diseases. They progress steadily, are resistant to therapy and often recur. Only some varieties in the initial stages of development can be treated with therapeutic methods. It is impossible to cure at home without resorting to medical help.
The prognosis depends on timely treatment, careful implementation of medical recommendations and treatment of the underlying disease against which the ulcer appeared.