Probably everyone knows about such a pathology as varicose veins. 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 completely neglected cases, the disease can lead to amputation of the limb or death of the patient from sepsis. Most often, the complication manifests itself in the form of trophic varicose ulcers of the leg. What is the cause of the disease and how to treat it, we will analyze in this article.
What it is?
Trophic ulcers are a serious, long-term non-healing skin defect that occurs due to the lack of treatment for varicose veins. Ulcers can develop with ineffective treatment and during the acute stage of pathology.
They appear in the place where the blood flow is most disturbed, as a result of which tissue nutrition is impaired. First, this area of the skin acquires a dark shade, then it 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 color. Initially, it can be one flat, rounded wound. In advanced cases, defects become many, they penetrate deeper and affect the tendons and bones.
Types of disease
Vein ulcer with varicose veins occurs in the late stages. At the initial stages of the disease, there is no marked violation of the blood supply. Gradually, the disease develops, and trophism is disturbed in the area of the altered vessels, causing the appearance of ulcers.
Such a defect has several types:
- point ulcers are small and develop around the enlarged nodes and veins;
- circulatory varicose ulcer covers the lower extremities almost throughout the entire circumference.
If 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:
- the appearance of a pronounced vascular network;
- a change in the color of the skin at the site of the appearance of the defect to a reddish-purple;
- the skin becomes smooth, shiny and swollen;
- itching and peeling of the epidermis occurs;
- in the absence of therapy, small point cracks may appear;
- crusts form around the entire circumference of the lower leg;
- after skin damage, 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 rotting of the tissues begins, which greatly complicates the patient's condition.
Diagnostics
From the point of view of diagnosis, a varicose ulcer with varicose veins presents some difficulties. In approximately 12% of cases, it is not possible to determine the cause of the disease. In the presence of such a disease, you must contact a phlebologist or a surgeon.
During the first consultation, the specialist conducts an oral survey of the patient, finds out what symptoms the patient is worried about and how long 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 an approximate picture of the disease and, perhaps, he will understand the root cause of the pathology. To confirm the diagnosis, the following tests are prescribed:
- General blood analysis. This study may indicate erythrocytosis or leukocytosis. The first indicator indicates increased blood viscosity, which leads to its poor outflow. The second indicates an inflammatory process.
- Blood chemistry. Allows you to evaluate cholesterol and glucose.
- A smear from an ulcer. It makes it possible to see the presence of pathological microorganisms in the wound, which may be the root cause of a violation of the integrity of the skin.
- Dopplerography of blood vessels. Using this study, the speed of blood in the veins and arteries is estimated.
- Computer angiography and MRI. The analysis helps specialists to consider the structure of blood vessels in the complex.
- Contrast angiography. A special substance is introduced into the vessels, which helps to examine in detail their anatomical sites on x-rays.
- Fluometry It resembles Dopplerography, only when using a laser beam.
Methods for treating varicose ulcers
Phlebology is a special section of vascular surgery that is developing 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 lengthy process. In order for the treatment procedure to be successful, it is necessary to carry out a whole range of therapeutic procedures that the doctor selects individually, based on the severity of the disease and the general history. Depending on the complexity of the pathology, several types of therapy can be used. Below we consider each in more detail.
Drug treatment
Treatment of varicose ulcers on the legs involves the treatment of the inflamed area with ointments, creams and medicinal solutions. To do this, use:
- Antiseptic agents such as Miramistin, Furacilin or Chlorhexidine. These drugs cleanse ulcers from accumulated pus and impurities and prevent pathogenic bacteria from developing in the wound. With prolonged use, drugs are used alternately so that resistance does not develop to them.
- Effective creams, ointments and gels that provide healing and soothing properties. Many of them speed up the process of skin repair. These include: "Solcoseryl" and "Methyluracil."
- Antibacterial drugs such as Tetracycline Ointment, Levomekol, Argosulfan are prescribed for treating wounds.
In the absence of a visible result from local treatment, antibiotics in tablets or injectable form are recommended. Particularly effective drugs that are characterized by a wide range of effects and allow you to get a quick result. These include cephalosporins, tetracyclines and penicillins. The dosage and duration of use are 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 starting treatment of varicose ulcers with potent drugs, it is necessary to try 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 this therapy:
- The application 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 ulcers from pus.
- The use of elastic bandages to reduce swelling and stimulate blood circulation. Compression underwear has the same effect.
- The use of drugs with a diuretic effect to stimulate metabolism and relieve swelling.
- The intake of vitamins and minerals.
- The use of drugs that restore blood circulation.
- Observance of the correct daily routine.
- Compliance with a special diet.
- Classes in therapeutic 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. She has positively proven herself and gives good results together with other methods of treatment.
Surgical intervention
Surgical treatment of varicose ulcers in the legs consists in excision of necrotic tissue and the focus of inflammation. Various methods are used for this:
- Catheterization of arteries and veins with prolonged ulcers.
- Vacuum removal of purulent contents using low pressure. A similar technique helps with various viral infections associated with the formation of ulcers.
- Cleaning with mechanical tools. Such an operation is painful and is performed under general anesthesia.
- A fairly common method is considered to be the method of flashing along the edges of an ulcer of 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 question may arise about the amputation of the affected limb. But such a decision is made only as a last resort.
Physiotherapy
Treatment with physiotherapeutic procedures is considered an auxiliary method. These include the following types of therapy:
- Magnetotherapy. It improves microcirculation and metabolic processes, which allows tissues to recover faster.
- Laser irradiation. It is carried out after mechanical cleaning, reduces the risk of pathology progression.
- Infrared irradiation. Accelerates the healing process.
Physiotherapy is used in courses that include 10-15 procedures. The duration of exposure is determined by the patient individually and ranges from three to ten minutes.
Baths are considered an effective method; 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 to consult 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 this quickly absorbs the components of the drug into the blood.
You need to be prepared for the fact that some medicinal products can cause allergic reactions. The main drugs in traditional 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. The composition of honey contains a large number of vitamins, trace elements and other beneficial substances. Honey and propolis eliminate inflammation, relieve swelling, nourish tissues. They can be used both for the treatment of varicose ulcers and lotions, and added to the composition of ointments in conjunction with other components.
- Chicken and quail protein. It is an effective folk remedy for the treatment of ulcers. It completely covers the skin surface 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, healing herbs are used, such as chamomile, celandine, and calendula. These infusions have antiseptic, anti-inflammatory, analgesic, antibacterial, cleansing and decongestant properties. All components must be connected in equal shares. Method of preparation: one tablespoon of chopped herbs is brewed with 200 ml of boiling water and infused for up to two hours. Then it is filtered and used as lotions or for the treatment of ulcers.
Phlebologists prevention tips
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 health, in particular the state of the vessels on the legs, a complication such as a trophic ulcer can always be warned in advance.
Phlebologists say that every person who has at least once encountered varicose veins or has a tendency to this pathology should know prevention methods that can save from the unpleasant consequences of the disease:
- the use of compression underwear;
- the use of special ointments and gels when puffiness or spider veins appear;
- body weight control;
- adherence to a special diet, as well as the exclusion from the diet of foods that retain water in the body;
- reduced foot load;
- gymnastics or physiotherapy exercises - swimming lessons are especially useful.
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 complications such as varicose ulcers on the legs.