About such a pathology as varicose veins, probably everyone knows. But not everyone has an idea of what the disease can lead to. Varicose ulcers appear if you start the disease and do not treat it. This is one of the most severe and dangerous consequences of varicose veins. In very advanced cases, the disease can lead to amputation of a limb or death of the patient from sepsis. Most often, the complication manifests itself in the form of trophic varicose ulcers of the lower leg. What is the cause of the disease and how to treat it, we will analyze in this article.
What is this?
Trophic ulcers are a serious skin defect that does not heal for a long time, which occurs due to the lack of treatment for varicose veins. Ulcers can develop with ineffective treatment and during the acute stage of the disease.
They appear in the place where the blood flow is most disrupted, resulting in poor nutritionfabrics. First, this area of the skin acquires a dark shade, then thickens, begins to itch and peel off. A sore spot becomes especially vulnerable. At this point, any damage to the skin can lead to the formation of a trophic ulcer. Varicose disease at this moment is in the third stage.
Outwardly, the ulcer looks like an open, inflamed wound of a dark red hue. Initially, it may be one flat, rounded wound. In advanced cases, there are many defects, they penetrate deep into and affect the tendons and bones.
Types of diseases
A varicose vein ulcer occurs in the later stages. At the initial stages of the disease, there is no pronounced violation of blood supply. Gradually, the disease develops, and trophism is disturbed in the area of altered vessels, causing ulcers.
Such a defect has several types:
- pinpoint ulcers are small and develop around enlarged nodes and veins;
- circulatory varicose ulcer covers almost the entire circumference of the lower limbs.
When this pathology occurs, it is necessary to begin immediate treatment, since such a complication sharply worsens the well-being of a sick person.
Symptoms
Trophic ulcers on the legs do not appear immediately. This process is preceded by some signs. These include:
- appearance of a pronounced vascular network;
- change in the color of the skin at the site of the defect toreddish purple;
- skin becomes smooth, shiny and puffy;
- there is itching and peeling of the epidermis;
- may cause small pitting cracks if left untreated;
- crusts form around the entire circumference of the lower leg;
- after damage to the skin, varicose ulcers begin to form;
- over time, the wound becomes deeper and wider, and muscles, tendons and bone tissue are involved in the pathological process;
- when bacteria enter the wound, the process of tissue decay begins, which greatly complicates the patient's condition.
Diagnosis
From the point of view of diagnosis, varicose ulcers with varicose veins present some difficulties. In about 12% of cases, it is not possible to determine the cause of the disease. In the presence of such a disease, it is necessary to contact a phlebologist or a surgeon.
During the first consultation, the specialist conducts an oral survey of the patient, finds out what symptoms bother the patient and how long ago they appeared. The doctor conducts a visual assessment of the skin defect and surrounding veins, finds out what and when the person was sick.
Already at this stage, the specialist will be able to determine the approximate picture of the disease and, perhaps, the root cause of the pathology will become clear to him. The following tests are ordered to confirm the diagnosis:
- Complete blood count. This study may indicate erythrocytosis or leukocytosis. The first indicator indicates increased blood viscosity, which causes its poor outflow. The second indicates an inflammatoryprocess.
- Biochemical blood test. Allows you to evaluate cholesterol and glucose.
- Smear from an ulcer. Provides an opportunity to see the presence of pathological microorganisms in the wound, which may be the root cause of violations of the integrity of the skin.
- Dopplerography of vessels. With the help of this study, the speed of blood movement in the veins and arteries is estimated.
- Computer angiography and MRI. The analysis helps specialists to consider the structure of blood vessels as a whole.
- Contrast angiography. A special substance is introduced into the vessels, which helps to examine in detail their anatomical regions on an x-ray.
- Fluometry. Reminiscent of Doppler, only the study uses a laser beam.
Methods of treating varicose ulcers
Phlebology is a special branch of vascular surgery that develops methods for the treatment and diagnosis of varicose veins, including complications that occur during the course of the disease.
Treatment of varicose trophic ulcers is a very complex and long process. In order for the treatment procedure to be successful, it is necessary to carry out a whole range of therapeutic procedures, which the doctor selects individually, based on the severity of the disease and general history. Depending on the complexity of the pathology, several types of therapy can be used. Below we consider each in more detail.
Medicated treatment
Treatment of varicose ulcers on the legs involves the treatment of the inflamed area with ointments, creams and medicinalsolutions. To do this, use:
- Antiseptics such as Miramistin, Furacilin or Chlorhexidine. These drugs cleanse the ulcer of accumulated pus and dirt and prevent the development of pathogenic bacteria in the wound. With prolonged use, drugs are used alternately so that resistance does not develop to them.
- Effective creams, ointments and gels that have healing and soothing properties. Many of them speed up the process of skin repair. These funds include: Solcoseryl and Methyluracil.
- For the treatment of wounds, antibacterial agents are prescribed, such as "Tetracycline ointment", "Levomekol", "Argosulfan".
In the absence of a visible result from local treatment, antibiotics in tablets or injectable form are recommended. Particularly effective are drugs that are characterized by a wide range of effects and allow you to get a quick result. These drugs include cephalosporins, tetracyclines, and penicillins. The dosage and duration of use is indicated by a specialist based on the individual characteristics of the course of the disease. Indeed, in order to achieve a positive effect, it is necessary to maintain a constant concentration of the antibiotic in the blood.
For a quick recovery, vitamin preparations and enzyme preparations are prescribed.
Pathogenetic therapy
Before you start treating varicose ulcers with strong drugs, you need totry pathogenetic therapy. It is aimed at eliminating the root causes of the disease, restoring normal blood circulation and increasing immunity. Here are some options for such therapy:
- The imposition of sterile dressings on the wound, soaked in medicinal decoctions and infusions. This procedure should be done regularly, at least three times a day. Decoctions are made from chamomile, calendula, celandine and other medicinal herbs.
- Cleansing of ulcers from pus.
- Using elastic bandages to reduce swelling and stimulate blood circulation. Compression underwear has the same effect.
- The use of diuretic drugs to stimulate metabolism and relieve swelling.
- Intake of vitamins and minerals.
- Using products that restore blood circulation.
- Keeping the correct daily routine.
- Following a special diet.
- Remedial gymnastics. If there are not too many ulcers, you can do a special set of exercises aimed at improving blood flow.
Pathogenetic therapy is most often auxiliary, especially in severe forms of varicose veins. It has proven itself and gives good results together with other methods of treatment.
Surgery
Surgical treatment of varicose ulcers on the legs consists in the excision of necrotic tissues and the focus of inflammation itself. Various methods are used for this:
- Artery and vein catheterization for long-term ulcers.
- Vacuumremoval of purulent contents with low pressure. A similar technique also helps with various viral infections that accompany the process of ulcer formation.
- Cleaning with mechanical tools. This operation is painful and is performed under general anesthesia.
- A fairly common method is the method of stitching along the edges of the ulcer the walls of the veins and arteries that feed this area.
- If a complication in the form of a trophic ulcer threatens the patient's life, the issue of amputation of the affected limb may arise. But such a decision is made only as a last resort.
Physiotherapy
Treatment with physiotherapy procedures is considered an auxiliary method. These include the following therapies:
- Magnetotherapy. Improves microcirculation and metabolic processes, which allows tissues to recover faster.
- Laser irradiation. Carried out after mechanical cleaning, reduces the risk of disease progression.
- Infrared irradiation. Accelerates the healing process.
Physiotherapy is applied in courses that include 10-15 procedures. The duration of exposure is determined by the patient individually and ranges from three to ten minutes.
Effective method are baths, they are air, sea, ozone and sodium chloride.
Folk remedies
In folk medicine, there are a large number of remedies based on medicinal plants that help in the treatment of varicose ulcers on the legs. But before using them, you need toconsult a doctor. This is necessary in order to exclude the possibility of complications. After all, not all folk remedies can be used on the open surface of the wound, since in this case the components of the drug are quickly absorbed into the bloodstream.
You need to be prepared for the fact that some medicinal products can cause allergic reactions. The main drugs in folk medicine, which are indicated for use in case of varicose ulcers, are:
- Aloe juice and Kalanchoe. Most often used in the form of compresses. Medicinal plants have antibacterial, anti-inflammatory and antiseptic properties.
- Honey and propolis. These products are famous for their unique healing properties. Honey contains a large amount of vitamins, minerals and other beneficial substances. Honey and propolis eliminate inflammation, relieve swelling, nourish tissues. They can be used both for treating varicose ulcers and applying lotions, or added to ointments along with other components.
- Chicken and quail protein. It is an effective folk remedy for the treatment of ulcers. It completely covers the surface of the skin where the defect is located, thereby creating a protective film. Due to this, pathogenic bacteria do not enter the wound.
- Infusions and decoctions. For cooking, medicinal herbs are used, such as chamomile, celandine, calendula. These infusions have antiseptic, anti-inflammatory, analgesic, antibacterial, cleansing and decongestant properties. All components neededcombine in equal proportions. Method of preparation: one tablespoon of chopped herbs is brewed with 200 ml of boiling water and infused for up to two hours. It is then strained and used as a lotion or to treat ulcers.
Tips for prevention phlebologists
Varicose ulcers of the lower extremities do not appear spontaneously, the development of the disease occurs over time, sometimes more than one year. Therefore, if you carefully monitor your he alth, in particular the condition of the vessels in your legs, such a complication as a trophic ulcer can always be prevented in advance.
Phlebologists say that every person who has ever encountered varicose veins or has a tendency to this pathology should know the methods of prevention that can save from the unpleasant consequences of the disease:
- use of compression underwear;
- use of special ointments and gels for puffiness or spider veins;
- weight control;
- following a special diet, as well as the exclusion from the diet of foods that retain water in the body;
- reducing the load on the legs;
- doing gymnastics or exercise therapy - swimming is especially helpful.
In addition, it is necessary to regularly visit a phlebologist or surgeon so that the doctor can assess the condition of the vessels, because only a specialist can notice pathological changes in the early stages of the disease. This will eliminate the problem quickly and prevent the development of suchcomplications like varicose ulcers on the legs.
