Modern aspects of the treatment of trophic ulcers

Treatment of trophic ulcers requires immediate initiation at the first suspicion of an ulcer. The approach to the treatment of a trophic ulcer is individual and depends on the cause of its development, the type, duration of the process and the characteristics of the organism. An accurate diagnosis requires a carefully collected history, an objective examination, a general and biochemical blood test, a coagulogram, cytological, histological, bacteriological studies and other studies. Treatment of trophic ulcers consists of drug therapy, surgery and physiotherapy.

When is the surgical method used to treat trophic ulcers?

Surgical method  used to remove dead tissue and eliminate the focus of inflammation. Methods of surgical therapy for the treatment of trophic ulcers:

• The catheterization method is used to treat trophic ulcers that do not heal for a long time (often these are venous and hypertrophic ulcers).
• Vacuum and curettage.
• Virtual Amputation Technique is used for neutrophic ulcers and consists of resection of the metatarsophalangeal joint and metatarsal bone without compromising the anatomical integrity of the foot. This eliminates problems with excess pressure.
• The technique of suturing percutaneous arterial fistulas is used to treat trophic ulcers of hypertensive origin in order to separate them. Surgical intervention is carried out along the edges of the ulcer.
• Vacuum therapy - negative pressure treatment (-125 mmHg), application of polyurethane sponge dressings.

This method makes it possible to effectively and quickly eliminate exudate from the wound and helps to reduce swelling around the ulcer, its size and depth, improves microcirculation of the tissues of the lower extremities. The method starts the process of formation of new granulations.

The use of drug therapy in the treatment of trophic ulcers

Drug treatment of trophic ulcers necessarily accompanies any surgical intervention. Also, treatment with conservative methods is used in the presence of initial manifestations of trophic ulcers.

The stage of weeping is the first stage in the development of a trophic ulcer, for the treatment of which such drugs are used:

• Broad-spectrum antibiotics.
• Anti-inflammatory drugs.
• Antiplatelet agents for intravenous administration.
• Antihistamines.

Local treatment of trophic ulcers at the first stage consists in removing dead tissues and cleansing the wound from pathogenic bacteria. To do this, wash the wound with antiseptic solutions and apply dry aseptic dressings.

Treatment of trophic ulcers at the second stage of development of the process

The second stage of the formation of a trophic ulcer requires healing agents, since the second phase is characterized by the process of healing and scarring. For this, special ointments and wound dressings with sviderm, algimaf, allevin, algipor and geshispon are used.

The use of compression bandages in the treatment of trophic ulcers

At all stages of the treatment of trophic ulcers, elastic compression should be performed. To do this, use a bandage of several layers of elastic bandage, which have limited extensibility. They need to be changed daily. Such a bandage is used for open ulcers of venous origin. Compression reduces the diameter of the veins, reduces swelling and improves the functioning of the lymphatic system of the lower extremities. It plays an important role in the treatment of trophic ulcers.

What methods of physiotherapy are used to treat trophic ulcers?

All types of treatment for trophic ulcers are improved by physiotherapy.

Methods of physiotherapy that are used to treat trophic ulcers:

• Ultrasonic low-frequency cavitation – enhances the effect of antimicrobials inside the wound.
• Magnetotherapy for decongestant, sedative, analgesic and vasodilating effect on the ulcer area.
                                    

• Local negative pressure in the Kravchenko pressure chamber - used in the treatment of atherosclerotic ulcers.
• Laser therapy is used to stimulate cell regeneration, relieve inflammation and excruciating pain in the lower limb.
• Ultraviolet radiation is used to increase the body's resistance to infections.
                                              

• Nitrogen and ozone therapy promotes better absorption of oxygen by the cells of damaged tissues and stimulates regeneration in the wound.

Mud therapy and balneotherapy are recommended for all types of trophic ulcers. In very severe cases, when the treatment does not work, a skin graft is performed, which is taken from the buttock.

The secret of successful treatment of trophic ulcers

Thus, for the successful treatment of trophic ulcers, in addition to establishing a diagnosis, it is important to determine the treatment regimen specifically for each patient. It is in the competence  only an experienced highly qualified specialist.

The doctor individually after the studies and on the basis of the clinical picture determines the treatment regimen, which indicates which methods of therapy and in what sequence should be applied to a particular patient with his type of trophic disorders.

Dr. Lirnik's Clinic of Vascular Pathology has been successfully treating trophic ulcers of any kind at the most advanced stages for many years. If you have a trophic ulcer, do not waste time, energy and health - contact Dr. Lirnik's clinic for qualified medical assistance, and the result will not keep you waiting!