Trophic ulcer
A trophic ulcer is a defect of the skin and tissues located under it that does not heal for a long time. With varicose lesions, ulcers appear in the lower third of the lower leg. The disease has a recurrent, progressive course. It is possible to achieve a complete cure only by removing the veins that have undergone pathological changes.
The development of trophic ulcers provokes the presence of:
chronic skin diseases;
violations of lymph outflow;
deterioration of arterial circulation;
chronic venous insufficiency;
chemical poisoning with arsenic or chromium;
some infectious diseases;
vasculitis;
pressure sores;
CAUSES OF TROPHIC ULCERS
As a result of a violation of venous blood flow, provoked by diseases of the venous system, blood is deposited in the lower extremities. There is a stagnation of the blood, in which all the waste products of the cells accumulate. As a result, there is a deterioration in the nutrition of cells, compaction of the skin and its soldering with subcutaneous tissue.
The presence of ischemia hinders the healing process of scratches and wounds, so even minor damage to the skin provokes the appearance of trophic ulcers. If an infection is attached, then various complications arise.
Any disease of deep or superficial veins complicated by chronic venous insufficiency can lead to the manifestation of trophic ulcers.
SYMPTOMS OF TROPHIC ULCERS
Before the symptoms of a trophic ulcer become visually noticeable, characteristic signs of venous system damage are observed. Patients complain of a feeling of heaviness in the calves and increased swelling. Muscle cramps that manifest at night become more frequent. It bothers the feeling of heat, burning and itching.
As hemosiderin accumulates in the skin, dermatitis and eczema appear. In the affected area, the skin becomes varnished in appearance, thickened, painful and tense.
With minimal damage to the skin, which the patient did not even pay attention to, the formation of a small ulcerative defect occurs. At the beginning of the disease, the ulcer is located superficially, but over time it deepens and expands, with the formation of extensive defects.
DIAGNOSIS OF TROPHIC ULCERS
During physical examination, varicose veins are found, which are located on the back of the thigh and lower leg. To assess the general condition of the venous system, ultrasound examination and ultrasound examination of the lower extremities are prescribed. To clarify the volume of microcirculation, rheovasography is prescribed.
TREATMENT OF TROPHIC ULCERS
In the treatment of this disease, a specialist should cover a number of problems. First of all, it is necessary to find out the underlying disease that provoked the onset of this pathological process. Then it is necessary to cope with the secondary infection. And finally, treatment of the trophic ulcer itself is required.
With general conservative therapy, the patient is shown drugs that are aimed at treating the underlying disease (antibiotics, antiplatelet agents, phlebotonics). Antibacterial therapy is prescribed after the sensitivity of the microflora is detected. Local treatment of ulcers involves the use of enzymes to treat secondary infection, and after the inflammatory process stops, local wound healing dressings.
Surgical treatment is prescribed after the preparatory stage, when there is a general normalization of the patient’s condition and healing of the ulcer. During the operation, venous blood flow in the affected area is restored.
