Trophic ulcer on the leg: treatment, photo, initial stage, symptoms

Trophic ulcer - a long-lasting non-healing defect of the skin and surrounding tissues, which appears as a result of disorders of blood and lymph circulation, rejection of the necrotic area, characterized by a slow development of granulation tissue, reduced rates of epithelialization and a tendency to relapse.

This is the most common severe complication of chronic venous insufficiency. Although the full trophic ulcer can not be called a complication. Most likely, the ulcer is the result of improper treatment or lack of it.

Causes of trophic ulcer

Such a skin defect is most often formed on the lower limbs, mainly in the distal parts( on the shins).Ulcers can be located on the ground, which are subjected to pressure - fingers and soles.

There are several reasons that lead to this pathology:

• chronic venous insufficiency against thrombophlebitis;
  
• disturbance of lymphatic drainage( chronic lymphostasis);
  
• trauma, in which the innervation of tissues is impaired;
  
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• dermatological diseases with chronic course( see how to treat eczema on the legs);
  
• diabetes;
  
• obesity;
  
• autoimmune diseases;
  
• chronic arterial insufficiency, which is accompanied by blockage of blood vessels or a sharp narrowing of the vessels;
  
• thermal( burns) and chemical lesions of the skin.

Even the most common abrasion can lead to the formation of trophic ulcers against a background of metabolic disorders, certain diseases and a weakened immune system. The triggering mechanism can be hypothermia and wearing crushing shoes.

Symptoms of a trophic ulcer on the foot: photo

If an open wound on the leg does not heal for more than six weeks is a trophic ulcer( see photo initial stage).

The classic site for its localization is the medial surface, but if the disease progresses, external manifestations can spread along the lateral surface of the shin.

Trophic ulcers on the foot do not occur suddenly, almost always their appearance is preceded by specific symptoms:

• painful sensations and burning sensation of the skin;
  
• edema of the lower extremities( see the causes of edema on the legs);
  
• severity in calf muscles;
  
• dilated veins;
  
• nocturnal cramps.

At the stage of development of seizures, the first visible changes begin to appear. As a result of leakage of lymph on the surface there is a symptom of "wet feet".The skin acquires a purple hue, coarsens, it becomes shiny. In such areas with hyperpigmentation and localized trophic ulcers.

They have a rounded irregular shape, often small or medium sizes, dense painful edges. Over time, there are spotting or purulent discharge. The location and appearance of ulcers depends on the underlying disease to which they were caused. The symptoms described above are typical for trophic ulcers of the lower extremities that occur with venous insufficiency.

In the pathology of the arteries, ulcers form on the feet. They are very painful, because they are constantly injured while walking. On the feet also occur diabetic ulcers( see the symptoms of diabetic foot), which can reach large sizes and depths, but not accompanied by pain syndrome due to nerve damage.

Treating trophic ulcers on the foot

The problem of treating trophic ulcers on the leg is very relevant in modern medicine. Venous ulcers of the shins are such a defect that it can cause significant damage not only to health, but also to the economic condition of a person. After all, therapy is quite serious and time-consuming.

In the case of trophic ulcers on the leg, treatment should be comprehensive and aimed at eliminating the main cause of the disease, there can be no question of independent treatment at home. The only way out is surgery, but it is possible only with the appropriate condition of the ulcer.

Therefore, the first stage of treatment is medicated and physiotherapy and serves as preparation for the operation. The main mechanisms of the impact on the wound are as follows:

• regular cleansing of excess wound detachable, since the deadened particles slow the healing;
  
• saving and maintaining a humid environment;
  
• decreased tissue edema;
  
• strengthening of local blood circulation with the help of microcirculatory improvers( trental, reopolyglucin);
  
• correction of carbohydrate metabolism( with diabetes mellitus);
  
• bed rest with raised limb to eliminate stagnation of lymph and blood;
  
• compression of the lower limbs to reduce stagnant phenomena( use of elastic bandage).

To accelerate the regeneration appoint physiotherapy methods: electrophoresis with drugs, magneto- and UHF-therapy. Infrared radiation is used to suppress pathogenic microflora without the use of antibiotics.


When these methods are used, the time for preparation of an ulcer for surgery is significantly reduced. Moreover, the volume of surgical interventions decreases, as well as the number of postoperative complications.

The main stage in the treatment of trophic ulcers of the lower extremities, as already mentioned, is surgical intervention, which is aimed at eliminating the immediate cause provoking the appearance of skin defects. It is carried out by removing the dilated superficial veins in varicose veins.

Bypass shunting, plastic arteries with an alloprosthesis is indicated for obliterating diseases. If the nerve is damaged, then neurolisis and autotransplantation of the nerves are indicated. Burn ulcers are excised, and the skin defect is replaced by a perforated flap.

Not one of the ways of surgical intervention can not be radical. Such treatment should be focused on an isolated effect on certain parts of the venous system, and should be achieved in a low-traumatic manner.

Complications of trophic ulcer

According to statistics, people suffering from this pathology permanently lose their ability to work, a high percentage of disability remains. During the study, fungi and anaerobic non-spore-forming organisms are often found in trophic ulcers. This circumstance indicates a high risk of sepsis development.

Most patients have complications in the form of contact dermatitis, pyoderma and eczema, as the skin condition worsens. When joining a bacterial infection, lymphatic vessels and nodes can become inflamed, an erysipelas infection often develops.

There is also the possibility of degeneration of trophic ulcers of the lower extremities into a malignant neoplasm, but this complication is extremely rare and is diagnosed in only 1% of patients. If not treated, the process can spread into the interior and involve subcutaneous fatty tissue, tendons, muscles and bones.

Prevention of

Prevention of the occurrence of trophic ulcers is a timely and qualitative treatment of the underlying pathology. So, with varicose veins, patients should:

• be kept from doing hard physical work;
  
• avoid prolonged stagnation;
  
• wear elastic bandages.

To prevent the development of ulcers in arteriosclerosis of vessels, it is possible using:

• adequate treatment;
  
• compliance with the hypo cholesterol diet;
  
• refusal from smoking and alcohol;
  
• physical education.

Diabetic ulcers can be prevented by:

• correction of blood glucose level;
  
• compliance with the diet;
  
• avoidance of hypothermia and injuries;
  
• wearing comfortable shoes.

Trophic ulcer is an ancient disease of human society, but the problem of its treatment and prevention remains relevant in our time.

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