Treatment of trophic ulcers
Photos before and after treatment of leg ulcers https://drkheirbeik.com/gallery
What do you need to know?
- Varicose ulcers are the most unpleasant complication of varicose veins.
- With the wrong approach to the treatment of a trophic ulcer, it can exist for weeks, months and even decades.
- Long-term ulcers can lead to disability, and ulcer treatment returns the patient to normal life.
- The most effective and easily tolerated treatment for the patient today is foam sclerotherapy of varicose veins under ultrasound control, which leads to the elimination of venous congestion and accelerated ulcer healing.
- The likelihood of relapse after foam sclerotherapy is minimal compared to other treatment methods.
- Do not delay ulcer treatment, after 2 weeks of treatment, if there is no healing, contact a surgeon, a phlebologist for help. This will prevent the expansion of the ulcer defect and reduce the treatment time.
A trophic ulcer of the leg is a skin defect in the form of an open wound that does not heal for more than a month. It is characterized mainly by a lack of tendency to self-healing, frequent exacerbations and progressive necrosis. However, the main feature of a trophic ulcer is its tendency to relapse (return) if the cause that caused it to appear is not eliminated.
Treatment of trophic ulcer of the leg with platelet-rich plasma: https://drkheirbeik.com/articles/lechenie-plazmoi
Photos before and after treatment of leg ulcers https://drkheirbeik.com/gallery
Diseases leading to the formation of trophic ulcers:
- Varicose disease of the lower extremities in 80-85% of cases.
- Obliterating atherosclerosis of the arteries of the lower extremities in 5-10% of cases.
- Diabetes mellitus in 5% of cases.
- Chronic skin diseases in 5 percent of cases.
Here we will talk about varicose ulcers of the leg and their treatment.
To our great fortune, treatment of varicose ulcers has become possible in 95%-97% of cases, thanks to foam sclerotherapy, which helps to rid the patient of varicose veins even in the most advanced and complex stages of the disease, without surgical intervention. Although trophic ulcer of the leg, until recently was considered a non-healing ulcer.
Causes of venous trophic ulcer:
In the dilated veins of the lower extremities, the venous valves do not close completely, and part of the blood moving towards the heart returns through the unclosed venous valves back, leading to an increase in blood pressure in the veins of the lower extremities, and, above all, in the leg, and over time this leads to swelling, which increases gradually and leads to disruption of metabolic processes and, thus, to prolonged oxygen starvation, which leads to trophic changes ending in a trophic ulcer (and sometimes several trophic ulcers).
Manifestation of the disease
The clinical picture consists of the appearance, most often in the lower third of the leg, of an ulcerative defect surrounded by a zone of altered skin. Ulcers can be either single or multiple, affecting one or both limbs at once. They usually have clear boundaries, edematous and infiltrated edges and are located on the inner surface of the leg, much less often - on the outer or back surface. With a long-term existence, the edges can scar and thicken, which can be determined by touch. Trophic ulcers in varicose veins are usually accompanied by severe pain, more pronounced at night.
Diagnostics of trophic ulcer
To diagnose trophic ulcer it is necessary:
- A thorough study of the medical history and other concomitant diseases.
- A thorough examination of the ulcer and the affected limb, photographing and measuring for comparison at different stages of treatment;
- Conducting additional research methods to confirm the diagnosis and, first of all, duplex scanning of the veins of the lower extremities (i.e. ultrasound).
What is the danger of a trophic ulcer?
A long-term trophic ulcer leads to large and deep changes in the leg, causing severe pain during the day and the most severe at night, thereby reducing the quality of life and leading to disability.
Treatment of trophic ulcers
For treatment to be effective, it must be aimed at eliminating the causes of the ulcer, and not just treating the ulcer itself. This approach gives us the opportunity to not only achieve rapid healing, but also to minimize the likelihood of relapse.
Treatment of varicose veins with trophic ulcers of venous origin can be surgical with the use of anesthesia or spinal anesthesia or non-surgical - carried out using foam sclerotherapy on an outpatient basis, without anesthesia and without hospitalization, which is very important, since most patients are elderly people with concomitant diseases, in which surgical treatment under general anesthesia is associated with a high risk, or is generally contraindicated.
Advantages of treatment with foam sclerotherapy
- Without hospitalization
- Without anesthesia or spinal anesthesia
- Without scars on the legs
- Without restrictions
Treatment with foam sclerotherapy under the control of ultrasound leads to the healing of varicose ulcers in 95% - 98% of cases, regardless of the duration of the ulcer, and to an improvement in the patient's quality of life. Often, such patients return to a normal lifestyle. This is confirmed by our experience in treating trophic ulcers for more than twenty years.
How we treat with foam sclerotherapy
Foam sclerotherapy is performed on an outpatient basis under ultrasound control, without anesthesia and without hospitalization and takes from 30 to 40 minutes. After the procedure, the patient leaves the clinic without the need for an escort, and leads a normal life, without any restrictions.
A visit to a specialist will be required no more than once every 7-15 days for 4 to 6 weeks. The number of visits depends on the extent, depth, infection, duration of the ulcer and the presence of concomitant diseases.
A follow-up examination and duplex scanning is performed 3 months after the ulcer has healed. Then after 6 months and, subsequently, every year, and also if necessary. Based on the results of the examination and the duplex scan (i.e. ultrasound examination), the degree of compression required in each specific case is selected.
How can I prevent ulcer recurrence (i.e. its reappearance)?
Healing of the ulcer does not mean a cure, since varicose veins are a chronic disease, and over time new varicose veins appear.
Prevention plays a major role in preventing and limiting recurrence.
It consists of the following:
- Wearing compression hosiery when standing, sitting and flying for a long time.
- Periodic bending and straightening the feet and raising the lower limbs for several minutes leads to unloading of the veins and a decrease in pressure in them. In general, all exercises that strengthen the muscles of the lower extremities lead to improved blood return from the lower extremities to the heart.
- Use creams that moisturize the skin of the shins and prevent it from drying out.
- Losing weight, eating fruits and vegetables, treating constipation and quitting smoking.
What we do not recommend:
- Laser therapy for ulcers since there is insufficient data on its effectiveness.
- Limit yourself to local treatment of the ulcer, since this can lead in the best case to a short-term effect with subsequent relapse and in the worst case to the expansion and deepening of the ulcer, which delays its further treatment.
- skin grafting to eliminate the ulcer without eliminating the cause of the ulcer since this can lead in the best case to a short-term effect and in the worst to prolongation of suffering patient.
Here I want to draw attention to the fact that eliminating the cause of the ulcer itself leads to its healing.
Cost of treatment https://drkheirbeik.com/price/phlebology