Trophic ulcer

The trophic ulcer is not an independent disease, but a complication of venous insufficiency of chronic character. It represents defect of skin or mucous membrane which develops because of destruction of surface fabrics. Fabric collapses because of change of a blood flow in a microcirculator bed and disturbance in the place of developing of an ulcer of an innervation. The disease is aggravated at hit of an infection and the continuing pathological processes in a vascular bed.

Trophic ulcers standing differ in recurrent long treatment, bad healing, disturbance of many aspects of quality of life of the diseased, and also often result in disability.

Origins of trophic ulcers

Most often trophic ulcers develop because of:

• Chronic diseases of veins on the lower extremities – a varicosity, thrombophlebitis with its effects;
• Obliterating atherosclerosis of arteries of the lower extremities of different caliber;
• Anatomic and inflammatory diseases of absorbent vessels – an acute and chronic lymphostasis;
• Diabetes mellitus and its complications;
• Thermal injuries – burns or freezing injury;
• Chronic dermatitis, including allergic;
• Injuries of nervous trunks with further disturbance of their integrity;
• Autoimmune diseases of connecting fabric which are followed by system disturbance of a blood flow in a venous, arterial and microcirculator bed.

Symptoms of trophic ulcers standing

Right at the beginning skin on the lower third of a shin (on an anteriointernal surface) begins to become thinner, becomes intense, dry and gains mirror gloss. On such skin there is characteristic nevus pigmentosus, then there is a small sore which gradually increases over time. Edges of an ulcer become dense, the bottom of an ulcer bleeds and becomes covered by a plaque of dirty color. In such state any small injury promotes connection of an infection and expansion of an ulcer.

The main complaint at trophic ulcers standing is pain. Because of an ulcer it is difficult for patient to select correctly footwear and to observe personal hygiene.

Diagnosis

At detection of trophic ulcers standing the main objective of the doctor – to define an etiology. The X-ray contrast flebografiya, dopplerography of vessels of the lower extremities, chrezkozhny measurement of oxygen level and other researches of a blood flow in the lower extremities is for this purpose carried out.

From laboratory analyses clinical analyses of urine and blood, immunological and biochemical researches, bacteriological researches separated from an ulcer for selection of antibacterial treatment are appointed.

Complications during a trophic ulcer

The progressing ulcer inevitably will cause increase in depth and area of skin defect, and hit in an infection will provoke development of a lymphangitis, erysipelatous skin inflammation, septic complications and lymphadenitis. Hit in an ulcer of anaerobic flora and a necrosis of fabric cause gas gangrene which demands urgent surgical treatment. Sometimes, especially if for treatment of long not healing ulcer aggressive drugs were used (salicylic acid, birch tar and others), the carcinoma cutaneum can develop.

Treatment of trophic ulcers

Treatment of trophic ulcers of the lower extremities has to be complex and directed both to local displays of pathology, and to elimination of a disease which resulted in necrotic defect.

Most often for treatment of trophic ulcers of the lower extremities the ulcer is closed by means of conservative actions, and further carry out surgical intervention on venous system. Treatment can be carried out as in a hospital, and at home, depending on a condition of the patient. As topical treatment the ulcer is cleared every day by means of the sponge or napkins impregnated with antiseptic solution apply a bandage with the healing ointment and carry an elastic bandage. After healing of an ulcer the remained hem needs to be protected from any possible traumatization.

The recipe of ointment for treatment of trophic ulcers of the lower extremities: it is necessary to pour one tablespoon of fresh sunflower oil in the enameled mug (not refined, it is desirable rural). Oil is boiled on the water bath twenty minutes. Further add one tablespoon of pharmaceutical fish oil to it and boil on the water bath twenty more minutes. Then it is necessary to take twenty five tablets of streptocide, to pound them and to pass through a sieve. The received powder pours out in a mug with oil and fish oil and all this is boiled for thirty minutes. The received ointment should be applied on trophic ulcers and to redress. The bandage needs to be changed every day. Two weeks of use of such ointment will help to get rid of a trophic ulcer.