Trophic ulcer: symptoms and treatment

A trophic ulcer is an inflammatory wound on the skin of the upper and lower extremities, which does not heal for six weeks or more. It appears because of insufficient blood circulation and nutrition of tissues that arise against the background of varicose veins. Such a disease can not occur on its own, but becomes an unpleasant and severe consequence after some diseases.



Trophic ulcers occupy one of the first places among purulent infections, because they are characterized by a painful course and a prolonged, difficult treatment. Such pathology can appear on any part of the skin, but in most clinical situations, tumors are localized on the lower limbs — from the feet to the knee. Among the most common symptoms of this disease are the severity of walking and swelling of the legs.

The first sign of such a disorder is the appearance of a small, but painful patch of bluish tinge. Further, ulcers develop, from which pus or blood can flow. This process is accompanied by an unpleasant odor. In order to completely cure such ulcers, you will have to resort to surgery.

Etiology

The causes of the appearance of trophic ulcers are divided into two groups. The first includes the impact of external factors, and the second — consists of internal processes occurring in the body, and complications of which are precisely such skin defects. But any of these reasons have a common feature — they arise because of insufficient flow of oxygen and nutrients through the veins.

The first group of reasons consists of:


  • a wide range of possible lower limb wounds;
  • burns;
  • frostbite
  • bedsores that appear after prolonged immobilization of a person
  • chemicals that a person can directly contact due to his work activity
  • Radiation exposure
  • wearing uncomfortable, narrow shoes

The second group of pathogens include infectious diseases and dermatological problems:


  1. diabetes;
  2. chronic venous and arterial insufficiency;
  3. impaired lymph drainage process
  4. various autoimmune diseases
  5. weakened immunity and impaired metabolism can lead to trophic ulceration, even from a minor cut
  6. a sudden increase in body weight;
  7. trauma to the brain or spinal cord
  8. Tuberculosis
  9. syphilis
  10. AIDS.

Trophic ulcers may appear from a combination of several causes of both groups. From the precise definition of the causes of the illness depends on the choice of the most effective treatment.

Symptoms

The first symptom that may indicate the progression of such a defect in the skin is the feeling of heaviness in the injured leg when walking, as well as the appearance of a bluish-gray patch that can be mistaken for a bruise. These two signs are not the only manifestations of the disease. The main symptoms also include:


  • noticeable swelling of the lower limbs;
  • the appearance of seizures in calves, the intensity of which increases at night;
  • severe burning and itching
  • the skin is sensitive to any touch;
  • Feel the heat in the leg
  • the skin of the affected leg may become compact;
  • the appearance of secretions from the skin reminiscent of sweat

With minor trauma to the leg, which already has the above symptoms, small ulcers appear on the skin, from which a purulent fluid with blood impurities can be released. Discharges very often have an unpleasant odor. Over time, without treatment, such ulcers expand not only in width, but also in depth, which can lead to severe acute pain during walking, up to the fact that a person can not walk, which means that his performance will decrease. Therefore, if you find the slightest signs of the disease, you should immediately seek help from a doctor.

Complications

The appearance of trophic ulcers on the legs and untimely treatment can lead to the progression of such complications:


  1. the formation of specimen-specific vesicles that eventually wither and become crusted
  2. cellulite skin coverage
  3. the appearance of the fungus
  4. Streptococcal skin lesions
  5. deformation of the joints
  6. destruction of the cartilages of the inflamed parts of the lower limbs;
  7. formation of thrombi in veins
  8. Oncological neoplasms, but this consequence is very rarely diagnosed (with a severe neglect of the pathological process).

Diagnostics

For experienced doctors, it is not difficult to determine the disease after examining the patient, due to specific symptoms and their characteristic localization. In general, the diagnosis is designed to determine the causes of trophic ulcers. If these were external factors, the patient should tell the doctor about them, and also tell the time interval when this happened. If such are infectious diseases, to confirm this, general and biochemical analyzes of urine and blood are carried out, the level of sugar is determined, and a laboratory study of the liquid isolated from ulcers is additionally assigned. The hardware examination of the patient includes:


  • Biopsy
  • Radiography using contrast medium
  • MRI of the lower limbs;
  • rheovasography, to determine the ripple frequency in a damaged location.

Treatment

Treatment of trophic ulcers should be aimed at eliminating the original source of the disease and preparing for surgical intervention, because this is the only way to permanently get rid of such a problem. In cases where the treatment of such a skin lesion with the help of surgery is impossible, a person should try not to allow the growth of the lesion. Therefore, trophic ulcer therapy consists of a complex treatment.

The first stage includes taking medications and physiotherapy, which will prepare for medical intervention and consist of:





  1. Cleansing the limb from previously dead skin particles
  2. reducing swelling
  3. enhancing blood circulation with medication
  4. providing bed rest with fixation of the affected leg above the level of the patient’s head. This is done in order to eliminate or prevent the stagnation of lymph and blood;
  5. taking antibiotics to eliminate viruses
  6. Compresses from an elastic bandage that changes several times a day and reduces the discharge from ulcers
  7. Electrophoresis with the use of medicinal substances;
  8. UHF

After the general condition of the patient has improved and the ulcers begin to heal, the next stage of treatment of trophic ulcers is the operation. This type of treatment has several approaches:


  • shunting, which will restore the flow of blood through the veins
  • removal of varicose veins
  • nerve transplantation — performed only in case of nerve damage
  • Prosthetics or replacement of cartilage, if during its course the structure was broken;
  • skin transplantation — if the cause of the trophic ulcer is a burn.

For a postoperative recovery, sanatorium conditions are best. It is strongly recommended to wear a bandage of elastic bandage and try to avoid any injuries to the lower extremities.

Popular methods of treatment are considered ineffective — all doctors categorically forbid treating trophic ulcers at home. The only thing a person can do is stick to a non-strict diet that involves limited use:


  1. salts;
  2. hot spices and sauces;
  3. Fast carbs.

Prevention

The main means of prevention is the timely treatment of diseases that can provoke the appearance of trophic ulcers. After surgery, patients should:


  • avoid injuries to the operated leg
  • refrain from excessive physical exertion
  • when leaving the street, always bandage with a flexible bandage the place that has undergone surgery;
  • eat lots of fresh fruits and vegetables
  • lead a healthy lifestyle



  • monitor blood sugar levels