Treatment of trophic skin disorders in swelling

Trophic ulcer is a defect in the skin or mucous membrane that occurs as a result of a disturbance in the supply of tissues.

The appearance of trophic ulcers is associated with poor nutrition, innervation and bacterial lesion of the skin area. As a rule, this is a consequence of the worsening of the course of the main chronic disease.

To provoke the appearance of trophic ulcersdiabetes mellitus, chronic venous insufficiency, thrombophlebitis, obliterating atherosclerosis of the arteries of the legs, allergic dermatitis, lymphatic vascular disease with impaired lymph circulation, burns of the lower limbs.

Before the occurrence of ulcerative defect of the patientworries puffiness and pain in the affected limb, burning and itching, heaviness in the legs. The skin in the place of defeat is stretched, shiny, purple or purple, painful on palpation. Over time, a round or elongated ulcer is formed that does not heal for a long time and causes great suffering.

Trophic ulcers are the most frequentcomplication of chronic venous insufficiency (CVI) and are found in 2% of the able-bodied population of industrially developed countries. In elderly people, the frequency of trophic ulcers reaches 4-5%. One can say with certainty that the treatment of trophic ulcers is one of the most important medical and social problems of modern society. Despite the obvious progress in the diagnosis and treatment of venous disorders of the lower extremities, the prevalence of trophic ulcers of venous genesis remains a kind of constant (1-2% of the adult population), identified as a result of numerous studies over the past 30 years. Decompensated forms of the disease are more common in elderly patients, but the initial manifestations of trophic skin and subcutaneous tissue disorders occur in most patients at a younger age. Trophic ulcers of the lower extremities represent a real threat to many aspects of the quality of life of patients. They are characterized by a low tendency to healing and a prolonged recurrent course leading to persistent disability of patients.

How is the trophic ulcer formed?

When the medium and small blood andlymphatic vessels, they create a stagnation of blood or lymph. The trophism of tissues and their supply with oxygen is disturbed. Decay products begin to destroy nerve fibers, and the attachment pathogenic microflora exacerbates the process.

With diabetes, trophic non-healingUlcers are often formed on the large toe and on the foot. Due to a decrease in sensitivity and hyperkeratosis, a patient may not notice the pathological process for a long time.

In thrombophlebitis, ulcers are usually formed on the shins.

The causes of trophic ulcers aredisturbances of venous circulation, arising in varicose and postthrombophlebitic diseases. As a result of valvular insufficiency of subcutaneous, perforating and deep veins, outflow of blood from limbs is broken, chronic venous hypertension is formed, which subsequently initiates a chain of pathological reactions leading to trophic changes and ulcers.

Formation of a venous trophic ulceroccurs, as a rule, in several stages. Initially, the skin of the lower leg, usually in the area of ​​the medial malleolus, forms a hyperpigmentation site, the appearance of which is associated with the deposition of hemosiderin pigment in the dermis (a product of hemoglobin degradation). After some time in the center of the pigmented area appears a dense patch of skin, which acquires a whitish, lacquer appearance, reminiscent of paraffin wax. The so-called "white atrophy" of the skin develops, which can be considered as a pre-ulcer state.

In the future, a minimal trauma results inthe emergence of a trophic ulcer, which with a timely begun treatment is quickly closed. Otherwise, the area and depth of the ulcer progressively increase, the perifocal inflammatory reaction of the soft tissues is joined - acute indurative cellulite. Perhaps secondary infection with the development of local and systemic purulent-inflammatory complications.

The stages of varicose leg disease leading to trophic ulcers

If there is an open or closed trophic ulcer, the prognosis is always negative, the situation is aggravated, mainly because of the use of incorrect treatment.

We have already found out that the main cause of the occurrence of trophic ulcers is varicose veins.

Now we will briefly consider all the stages of varicose veinsdiseases that lead to the formation of open, then - open trophic ulcers, as well as find out which treatment is most often recommended at each stage of the disease.

The first stage: Reticular veins and vascular sprouts on the skin.

This problem is most often found in women (under the influence of natural estrogens, the intracutaneous veins and capillaries expand), when the reticular veins and capillaries are enlarged.

Medication can be the mostdiverse. One of the best treatment options for vascular asterisks is microsclerotherapy, during which microinjections of the drug Fibrovein are made. In parallel, it is necessary to use the compression regime for several days.

The second stage: Phlebeurysm.

Varicose veins are the main symptomdiseases of varicose veins. The reason is the low efficiency of the valves of the veins. In addition to aesthetic discomfort, rapid fatigue of the legs, discomfort and "heaviness in the legs" are often observed. In Europe, the most effective method (efficiency reaches 100%) is Echosclerotherapy (the introduction of sclerotherapy under the control of an ultrasound scanner). One of the modern sclerotherapy is Fibrovein. Other methods of treatment of this stage of varicose disease are worthy of attention: laser, radiofrequency and surgical therapy.

The third stage: Significant puffiness of the legs.

At this stage of the disease, in addition to treatmentvaricose veins, treatment is required, which is aimed at eliminating edema of the legs. For treatment I can apply and diuretics and compression jersey and pneumomassage.

Fourth stage: The beginning of trophic disorders.

At this stage of development of varicose veinsthe metabolic processes sharply worsen, as a result, the skin of the lower third of the shin becomes darker, thickens, inflammation forms and the development of the disease becomes less and less reversible. Treatment is similar to the previous stages.

Fifth stage: Open or healed trophic ulcer.

A dangerous stage of the disease, which requires special attention and treatment. At this stage, there is a very high risk of re-opening the ulcer or the initial opening of a trophic ulcer.

Sixth stage: Open trophic ulcer.

The most dangerous stage of the disease, requiringimmediate and intensive treatment both inside and out. It is strongly recommended the use of drugs that improve the venous and capillary circulation and eliminate puffiness. In addition to all the previous recommendations, it is required to begin an intensive course of treatment of an open wound and its healing. The most effective drug for the treatment and healing of an open trophic ulcer of any complexity is Iruksol. European surgeons primarily appoint Iruksol for the treatment of trophic and other ulcers, since the use of this drug when healing any complex wounds is close to 100%. The use of Iruksol significantly reduces the duration of treatment and does not require special skills and knowledge, except for the doctor's recommendations.

Deliver an accurate diagnosis and prescribe treatmenthelp the survey and examination of the patient. Mandatory general tests of urine and blood are carried out. Separated from the surface of the ulcer is investigated for sensitivity to antibiotics. Conduct an ultrasound and dopplerography of the vessels of the legs, angiography.

The use of Iruksol ointment for the treatment of open trophic ulcers

The difference of trophic ulcers from other types of wounds inthat treatment of an open trophic ulcer should be started immediately, in order to avoid infection with infection and other more serious complications. Reduction or increase in the duration of treatment of trophic ulcers also depends on the use or non-application of treatment for the causes associated with the formation of trophic lesions and varicose complications in general.

The difference of trophic ulcers from other types of wounds inthat treatment of an open trophic ulcer should be started immediately, in order to avoid infection with infection and other more serious complications. Reduction or increase in the duration of treatment of trophic ulcers also depends on the use or non-application of treatment for the causes associated with the formation of trophic lesions and varicose complications in general.

Treatment of trophic ulcers is a complex and long process. The sooner the first trophic changes are seen, the more successfully and quickly will be treated.

Basic principles of therapy of trophic ulcers:

  1. The use of therapeutic compression knitwear to improve blood and lymph circulation in the affected limb.
  2. Decrease in venous pressure.
  3. The appointment of angioprotectors, antibiotics, antiallergic agents for oral administration.
  4. Regular wound toilet. Local application of anesthetic, antibacterial, wound healing ointments.

Good effect in the treatment of trophic ulcershas the use of ointment Iruksol. It provides a comprehensive action and does not require the use of other local means. Ointment Iruksol cleans the wound of deadened remains, has an antibacterial effect, accelerates the healing of the ulcer. Iruksol is effective in any ulceration of the skin, regardless of localization.

In its combination, the ointment containsenzymes that decompose the dead tissue areas, depriving microbes of the nutrient medium, and the antibiotic chloramphenicol disastically affects the pathogenic microflora.

How to properly apply Iruksol for the treatment of trophic ulcers

Bandages with Iruksol are superimposed on the areatrophic ulcer 2 times a day, although in the first days, a more frequent change of dressings is possible. Before applying the dressing, be sure to rinse or moisturize the surface with saline. No other solutions should be used. On the edge of the wound, you can apply zinc paste. Combination of Iruksol with other drugs is contraindicated. Treatment is carried out until the full healing of the trophic ulcer.

The use of Iruksol is contraindicated in pregnancy, lactation, blood diseases and intolerance to chloramphenicol.

To prevent the occurrence of trophic ulcersit is important to conduct daily preventive examinations of the limbs, to treat any cracks, wounds and abrasions in a timely manner, as well as to adequately treat the underlying disease.