Causes of trophic ulcers, symptoms, treatment
A trophic ulcer is a soft tissue defect that does not heal for a long time. The main cause of the appearance of a trophic ulcer is a violation of local blood circulation (at the tissue level) or a failure of innervation. Pathology is very difficult to treat - it is resistant to many methods of influence.
Reasons
A trophic ulcer on the leg is the most common form of this pathology, although such non-healing wounds can develop on any part of the human body.
Most often, trophic ulcers are formed against the background of the following conditions:
- chronic venous insufficiency;
- disruption of lymphatic drainage;
- toxic effect on tissues;
- long stay in a lying position.
They are observed in the following nosologies:
- varicose veins (most often leads to the development of chronic venous insufficiency);
- post-thrombophlebitic disease – a condition after inflammation of blocked veins;
- hypertensive disease – regular increase in blood pressure (often critical);
- diabetes. Trophic ulcers in diabetes are one of the frequent phenomena;
- atherosclerosis – deposition of cholesterol on the inner surface of blood vessels with subsequent narrowing of their lumen and deterioration of blood flow;
- defrosting;
- burns;
- vasculitis – impression of vessel walls with their subsequent destruction;
- chromium or arsenic poisoning.
It was found that the cause of the appearance of trophic ulcers in 70% of all cases is vein disease. At the same time, the venous outflow from the tissues is disturbed, their blood stagnates, as a result, tissue and cellular waste products accumulate, which leads not only to tissue starvation, but also to the formation of a trophic ulcer.
Symptoms
The formation of a trophic ulcer is preceded by the following signs:
- edema;
- skin hyperpigmentation;
- muscle cramps;
- itching;
- sensation of heat;
- heartburn.
Next, a surface defect appears in the affected area, which gradually expands and deepens. Characteristics of a full-fledged trophic ulcer:
- by shape – first round, then irregular;
- in size - from a match head to a significant impression of soft tissues;
- according to the features of the bottom - it is dark red, covered with a white-dirty plaque, and then with a scab;
- according to the features of the surrounding tissues – their maceration (corrosion) is noted.
General symptoms (convulsions, edema) with trophic ulcers of the lower extremities persist.
Diagnostics
A trophic ulcer is detected by direct inspection. For diagnosis and determination of treatment tactics, anamnestic data are important: when and against what background the trophic ulcer appeared, what changes occurred, whether treatment was carried out.
Additional research methods involved in the diagnosis of this pathology and provocateur diseases:
- functional tests;
- ultrasound dopplerography of veins;
- ultrasound duplex scanning;
- general blood test;
- blood sugar analysis;
- biochemical analysis of blood.
Treatment of trophic ulcers
Treatment goal:
- restoration of tissues at the site of trophic ulcer;
- improvement of microcirculation in the place where the ulcer formed.
It plays a role in the treatment of diseases that led to the development of trophic ulcers.
Treatment of trophic ulcers is based on the following purposes:
- phlebotonics;
- antibacterial drugs;
- antiaggregants;
- enzymes (to clean the ulcer);
- local antiseptics;
- ointment bandages.
In general, the treatment depends on the causes of the trophic ulcer, stages, progression.
In the absence of an effect from conservative treatment, an operation is performed, the purpose of which is to correct the arterial and venous blood supply in the affected area. Excision of a trophic ulcer is not effective if the cause of its occurrence is not eliminated.
Prevention and prognosis
The main measures for the prevention of trophic ulcers:
- dosage of physical activity;
- treatment of pathologies that can lead to the development of a trophic ulcer;
- with the development of venous insufficiency - prohibition of physical work, wearing elastic bandages (in case of damage to the lower extremities).
Prognosis for trophic ulcer is difficult. The ulcer itself is not dangerous for human life, but it leads to disability and permanent deterioration of the quality of life.
You can learn more about trophic ulcers from our specialists by signing up for a consultation on the website Dobrobut.com. Patients are most concerned about the causes of trophic ulcers on the legs, their treatment and prevention.
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