Trophic ulcer is a disease caused by the rejection of dying tissue, resulting in the appearance open wound skin. Such an ulcer develops in parallel with other diseases, such as varicose veins, eczema, venous insufficiency. This disease usually affects the lower extremities. You can see what trophic ulcers on the legs look like in the photo; the initial stage has pronounced symptoms.
The following signs of the initial stage of a trophic ulcer on the leg occur:
- painful sensations of the skin and its burning;
- the appearance of swelling in the legs;
- venous expansion;
- heaviness in the lower extremities when walking;
- sudden convulsions.
What does the disease look like in the initial stage (see photo)? The appearance of seizures begins to be accompanied by visual changes. The skin on your legs begins to change color, turning blue or purple. Increased moisture appears in the legs as a result of the passage of lymphatic fluid through the skin. Over time, the resulting wound begins to fester.
It is important to know! If a regular wound on the leg does not disappear within 1 month, it is a trophic ulcer! You need to immediately contact a specialist who will find out the cause of the disease and prescribe the correct treatment.
Causes of the disease
The following factors can serve as prerequisites for the disease:
- disorders in arterial and venous circulation;
- diabetes;
- mechanical impact on the skin can cause burns or frostbite;
- poisoning with highly toxic substances;
- , eczema;
- deterioration local circulation as a result of prolonged immobility.
Important! When establishing a diagnosis, the disease that caused the ulcers plays a very important role! This way, the specialist will be able to prescribe the correct treatment.
Types of trophic ulcers on the legs
Depending on the cause of the disease, there are the following types:
Arterial
This type of lesion occurs due to atherosclerosis, which disrupts the functioning of the main arteries. The cause of development is usually severe hypothermia, even frostbite. The location of the ulcer is most often the area of the foot, thumb legs, heel. A person is constantly cold, quickly overtired, and the affected leg begins to hurt at night. If this type of disease is not treated at the initial stage, the resulting wounds begin to spread throughout the foot and fester.
Venous
Usually appear with inside shins. The occurrence is associated with a complication of varicose veins. What does a trophic ulcer look like in the initial stage? The initial stage is accompanied by swelling of the calf, the appearance of cramps at night, a venous network is formed, and the color of the skin changes. If treatment is not started, the disease will progress and affect not only the skin, but also tendons and muscles. Pus with a pungent odor begins to ooze out. Incorrectly chosen treatment can lead to more severe illnesses.
Diabetic
With diabetes mellitus there are many concomitant diseases, including diabetic ulcers. The initial stage is characterized by death nerve cells, as a result of which the sensitivity of the legs is lost. Mainly susceptible to damage thumbs legs The danger of this type of disease lies in susceptibility to various types of infections, as a result of which gangrene can develop, followed by amputation.
Neurotrophic
The appearance is caused severe injuries head or spine. Most often affected side surface feet. The size of the formation is small in appearance, but very deep. The wound begins to fester rapidly.
The most rare type of disease. It is a consequence of constantly increased. Mostly women over 40 years of age suffer. The initial stage of a trophic ulcer on the leg of this type is characterized by a change in the color of the skin and mild swelling. If the disease is not treated for a long time, then small wounds appear, the number of which increases rapidly. Accompanied by severe unbearable pain.
Pyogenic ulcers
Prerequisites for the appearance may be skin diseases and decline immune system. Most often, this type of disease affects people who do not follow hygiene rules.
Important to remember! Regardless of the cause of its appearance and type, treatment of the disease should begin at early stages! After all, going to the doctor in case of a severe form of the disease can lead to fatal consequences.
How to treat the resulting wounds? The fight against the disease is divided into 3 stages:
- Conservative treatment. Treatment of an initial stage trophic ulcer consists of eliminating the symptoms of the disease. For this, the following drugs are used: Actovegil, Tocopherol, Solcoseryl and their analogues.
- Local treatment. First, you should act on the disease that was the cause of the damage to the lower extremities. Treatment should then be directed towards eliminating the infection, getting rid of dead tissue and addressing the wound. For such activities, antibacterial drugs (Furacilin, Chlorhexidine), antibiotics are used wide range, anti-allergenic medications (Suprastin, Tavegil), compresses with medicinal ointments(Levomikol, Dioxikol).
- Surgical intervention. The indication for this type of treatment is the widespread spread of ulcers along the lower extremities with a high degree of severity. The operation involves the elimination of the ulcer and surrounding necrotic tissue. The second stage involves surgery on the veins.
Important to remember! Surgery can be avoided thanks to a quick response at the initial stage of the disease!
Complications when legs are affected
A late visit to the doctor can have serious, even fatal, consequences:
- loss of ability to work, disability;
- the emergence of infectious diseases;
- deterioration of the skin condition.
Therefore, such wounds should be disposed of as quickly as possible and their occurrence should not be ignored.
Preventive actions
Home preventive measure is timely treatment diseases that cause trophic ulcers. You should also adhere to the following rules:
- abstaining from heavy physical work, especially for women;
- lead an active lifestyle;
- wear an elastic bandage during an exacerbation;
- proper nutrition;
- giving up cigarettes and drinking alcohol;
- avoid injury;
- choose only comfortable shoes for everyday wear.
It should also be remembered that after complete recovery from the disease, reappearance is not uncommon. Therefore, it is important to follow your doctor's recommendations during the recovery period. Be sure to study therapeutic exercises to maintain blood vessels in a state of elasticity. And also treat the affected areas with moisturizers and bactericidal agents.
Main symptoms:
- Discharge of pus and blood from the ulcer
- Skin discharge
- Discharge from an ulcer with an unpleasant odor
- Swelling of the lower extremities
- Feeling of heat in the leg
- Increased skin sensitivity
- A bluish-gray spot on the leg
- Decreased performance
- Heaviness in the injured leg when walking
- Thickening of the skin of the affected leg
A trophic ulcer is an inflammatory wound on the skin of the upper and lower extremities that does not heal for six weeks or more. Appears due to insufficient blood circulation and tissue nutrition, which occurs against the background of varicose veins. Such a disease cannot occur on its own, but becomes an unpleasant and serious consequence after certain diseases.
Trophic ulcers occupy one of the first places among purulent infections, because they are characterized by a painful course and long, difficult treatment. This pathology can appear on any part of the skin, but in most clinical situations, neoplasms are localized on the lower extremities - from the feet to the knee. Among the most common symptoms of this disease are heaviness when walking and swelling of the legs.
The first sign of such a disorder is the appearance of a small but painful spot of a bluish tint. Next, ulcers form, from which pus or blood may leak. This process is accompanied by an unpleasant odor. In order to completely cure such ulcers, you will have to resort to surgery.
Etiology
The causes of trophic ulcers are divided into two groups. The first includes the influence of external factors, and the second consists of internal processes, occurring in the body, and the complications of which are precisely such skin defects. But any of these reasons have common feature- they occur due to insufficient oxygen flow and nutrients through the veins.
The first group of reasons consists of:
- a wide range of possible wounds of the lower extremities;
- burns;
- frostbite;
- bedsores that appear after prolonged immobilization of a person;
- chemical substances that a person may come into direct contact with due to their work activities;
- radiation exposure;
- wearing uncomfortable, narrow shoes.
The second group of pathogens includes infectious diseases and dermatological problems:
- venous and arterial insufficiency of a chronic nature;
- impaired process of lymph outflow;
- various autoimmune diseases;
- weakened immunity and impaired metabolism can lead to the appearance of a trophic ulcer even from a minor cut;
- a sharp increase in body weight;
- brain or spinal cord injuries;
Trophic ulcers can appear from a combination of several causes of both groups. From precise definition The causes of the disease depend on the choice of the most effective treatment.
Symptoms
The first symptom that may indicate the progression of such a skin defect is a feeling of heaviness in the injured leg when walking, as well as the appearance of a bluish-gray spot, which can be mistaken for a bruise. These two signs are not the only manifestations of the disease. The main symptoms also include:
- noticeable swelling of the lower extremities;
- the appearance of cramps in the calves, the intensity of which increases at night;
- severe burning and itching;
- skin is sensitive to any touch;
- feeling of heat in the leg;
- the skin of the affected leg may become thicker;
- the appearance of sweat-like discharge from the skin.
With a minor injury to the leg, which already has the above symptoms, small ulcers appear on the skin, from which purulent fluid mixed with blood may be released. Discharges very often have bad smell. Over time, without treatment, such ulcers grow not only in width, but also in depth, which can lead to severe acute pain while walking, to the point that the person will not be able to walk, which means his performance will decrease. Therefore, if you detect the slightest signs of the disease, you should immediately seek help from a doctor.
Complications
The appearance of trophic ulcers on the legs and their untimely treatment can lead to the progression of the following complications:
- the formation of eczema - specific blisters that dry out and crust over time;
- covering the skin with cellulite;
- the appearance of fungus;
- streptococcal skin lesions;
- joint deformation;
- destruction of cartilage in inflamed areas of the lower extremities;
- formation of blood clots in the veins;
- oncological neoplasms, but such a consequence is diagnosed very rarely (with severe neglect of the pathological process).
Diagnostics
For experienced doctors, it will not be difficult to determine the disease after examining the patient, due to specific symptoms and their characteristic localization. Diagnostics is mainly intended to determine the causes of trophic ulcers. If they were external factors, the patient must tell the doctor about them, and also report the period of time when this happened. If these are infectious diseases, to confirm this, general and biochemical tests of urine and blood are carried out, sugar levels are determined, and additional prescriptions are prescribed. laboratory test fluid secreted from ulcers. Hardware examination patient will include:
- biopsy;
- radiography using a contrast agent;
- MRI of the lower extremities;
- rheovasography to determine the frequency of pulsation in the damaged area.
Treatment
Treatment of trophic ulcers should be aimed at eliminating the original source of the disease and preparing for surgery, because this is the only way to get rid of this problem forever. In cases where it is not possible to treat such a skin lesion with surgery, a person should try to prevent the lesion from growing. Therefore, therapy for trophic ulcers consists of complex treatment.
The first stage includes taking medications and physical therapy, which will serve as preparation for medical intervention and consist of:
- cleansing the limb from previously dead skin particles;
- reducing swelling;
- increasing blood circulation with medications;
- ensuring bed rest with fixation of the affected leg above the level of the patient’s head. This is done in order to eliminate or prevent stagnation of lymph and blood;
- taking antibiotics to eliminate viruses;
- a compress made from an elastic bandage, which is changed several times a day and will reduce discharge from ulcers;
- electrophoresis with the use of medicinal substances;
After general state the patient will improve, and the ulcers will begin to heal, the next stage of treatment of trophic ulcers will begin - surgery. This type of treatment has several approaches:
- bypass surgery, which will restore blood flow through the veins;
- removal of varicose veins;
- Nerve transplantation – performed only in case of nerve damage;
- prosthetics or cartilage replacement if its structure was damaged during the course of the disease;
- skin grafting – if the cause of the trophic ulcer is a burn.
For post-operative recovery, sanatorium conditions are best suited. It is strongly recommended to wear an elastic bandage and try to avoid any injuries to the lower extremities.
Traditional methods of treatment are considered ineffective - all doctors categorically prohibit treating trophic ulcers at home. The only thing a person can do is stick to not strict diet, which provides for limited use:
- salt;
- hot spices and sauces;
- fast carbohydrates.
Prevention
The main means of prevention is timely treatment of diseases that can provoke the appearance of trophic ulcers. After surgery, patients should:
- avoid injury to the operated leg;
- refrain from excessive physical activity;
- When going outside, always bandage the area that underwent surgery with an elastic bandage;
- eat plenty of fresh fruits and vegetables;
- lead healthy image life;
- monitor your blood sugar levels.
Is everything in the article correct from a medical point of view?
Answer only if you have proven medical knowledge
A trophic ulcer is a pathology in which deep damage to the skin occurs, resulting from the rejection of necrotic tissue. The disease develops slowly and is difficult to treat; in addition, trophic ulcers are prone to frequent relapses.
Trophic ulcers are not an independent disease; they usually occur against the background of other diseases, for example, diabetes mellitus, atherosclerosis, varicose veins veins, etc. Ulcers require compulsory treatment, otherwise the disease can cause serious complications, including amputation of a limb.
There are several reasons why pathology occurs; depending on them, the disease is divided into several types. As a rule, all trophic ulcers arise due to impaired blood supply to the tissues, as a result they begin to die. Various negative factors and diseases can provoke this condition.
Atherosclerotic
This pathology is associated with ischemia of leg tissue with atherosclerosis, that is, a blockage of the vessel occurs and blood circulation in the affected area is disrupted. The disease can be associated with various injuries, as well as with compression of the vessel, when wearing tight and uncomfortable shoes.
Such ulcers are most often localized on the feet and fingers; they are small in size, fester, and the wound has ragged edges, the skin around it is yellow. Elderly people are more susceptible to this pathology, since disorders associated with blood circulation may occur in the body.
In this case, even before the ulcer appears, a person suffers from night pain in the legs, lameness appears when moving, and convulsions may occur. In addition, a sign of poor circulation is pale skin color; the leg will appear marbled and cold to the touch compared to the rest of the body.
Hypertensive
This pathology is quite rare and is associated with a constant increase in blood pressure. With increased blood pressure the walls of blood vessels spasm, blood circulation in the affected area is disrupted and tissues begin to die, provoking the appearance of ulcers.
Interestingly, such ulcers appear symmetrically on both legs, and women over 45 years of age are more susceptible to it. The first symptom of the pathology is redness of the skin on the legs; the disease progresses slowly and is accompanied by severe pain.
Venous
Such trophic ulcers of the lower extremities appear when a vein is damaged; they are often associated with varicose veins and are their complication. The first symptoms of this pathology are enlarged veins in the legs, the appearance vascular network and itching.
If the disease is not treated at this stage, characteristic red spots appear in the area of enlarged veins, which increase over time, thus causing a trophic ulcer. The wound festers, hurts, emits an unpleasant odor, and as a complication, sepsis occurs and death is possible.
Diabetic
Most often, skin ulcers occur with diabetes; this condition is called diabetic foot - this is a serious complication that often provokes amputation of a limb and the death of the patient.
The main symptom of a diabetic foot is a violation of its sensitivity. If a person does not monitor sugar levels, then, most likely, damage to the nerves of the lower extremities will occur, which will disrupt sensitivity in the legs.
As a result, the patient stops feeling pain and can easily injure the foot and not notice the presence of a wound. As you know, in diabetes, blood clotting is impaired and wounds heal poorly, and with insufficient care, even a small scratch can become infected, which can cause an ulcer.
Infectious
Such a trophic ulcer is associated with direct infection in the skin, usually with weakened immunity. People who do not maintain personal hygiene and lead an asocial lifestyle are more susceptible to this pathology. Infectious trophic ulcers can be pinpoint or large. As a rule, they are shallow and fester strongly.
Symptoms
The symptoms of a trophic ulcer depend on its type. As a rule, the disease occurs gradually and is a complicated form of another disease, for example, diabetes mellitus, circulatory disorders, infectious infection wounds.
At first, the patient experiences cramps and pain in the affected limb at night; swelling, burning and itching may appear. Over time, hyperpigmentation of the skin begins to appear, which progresses quite quickly, the size of the spots gradually increases, and dermatosis or eczema may occur.
Then the skin becomes inelastic, thick, shiny and painful to the touch. Quite often, lymphostasis also develops, then small droplets of lymph appear on the skin, which seep from the inside. Then a white atrophy appears in the center of the spot, which is the beginning of the appearance of an ulcer.
At the initial stage, the trophic ulcer is located in the upper layers of the skin, but over time it grows and spreads deeper and deeper. In this case, the pain increases significantly; in severe cases, the ulcer affects not only the subcutaneous layers, but also tendons and even bones, then osteomyelitis occurs.
There is also discharge from the ulcer, the type of which depends on what kind of infection has attached to the ulcer; as a rule, suppuration is observed. The attachment of fungi accelerates the growth of the wound and can also cause microbial eczema around the ulcer, which significantly worsens the patient’s condition.
Diagnostics
Only a phlebologist can determine the causes and treatment of trophic ulcers; self-medication for such pathology is very life-threatening. As a rule, identifying a trophic ulcer is not difficult, and its occurrence is usually associated with a history of varicose veins or diabetes mellitus, thrombosis of the veins of the lower extremities, etc.
As a rule, a trophic ulcer is localized on the inside of the leg; dermatitis or rashes characteristic of eczema are often observed around it, and the patient complains of pain and itching. To clarify the diagnosis, the doctor will order the following tests:
- Blood and urine tests;
- Ultrasound Dopplerography of the veins of the lower extremities;
- Impedance plethysmography of the lower extremities, etc.
Treatment
Treatment of pathology takes long time, it is complex and should be carried out as early as possible. As a rule, there is no specific treatment tactics, since each specific case requires different therapy, it all depends on the cause of the ulcer, the presence of infections, chronic pathologies in the body, as well as the advanced state of the disease.
On initial stages Treatment of trophic ulcers on the legs is carried out conservative methods. The patient is prescribed to take medications, use local remedies, attend physical therapy. In advanced cases, you can only get rid of the disease surgically. Regardless of the cause, a trophic ulcer requires timely and adequate treatment, otherwise very serious complications are possible.
Conservative
Conservative treatment of trophic ulcers in diabetes mellitus or varicose veins is possible only at the initial stage. Purpose drug treatment is to stop the growth of the ulcer, get rid of the infection and the symptoms of the disease.
In general, the following groups of drugs are prescribed:
- Antibiotics for bacterial infections;
- Antifungal agents in the presence of fungus in the body;
- Non-steroidal anti-inflammatory drugs to relieve inflammation and pain;
- Antihistamines, they help with itching and reduce the symptoms of dermatitis and eczema, and prevent rashes.
- For severe swelling, diuretics may be prescribed.
- For increased nervous excitability and insomnia, sedatives are prescribed.
- Vitamins and immunomodulators are indicated to strengthen general immunity.
In addition, it is necessary to assign specific treatment, which is aimed at eliminating the cause of trophic ulcers and other associated diseases. Here you may need to consult a therapist, neurologist, endocrinologist, rheumatologist and other specialized specialists if necessary.
In addition to tablets and injections, patients are prescribed local remedies. They help speed up the healing of ulcers, relieve unpleasant symptoms, and relieve inflammation. For trophic ulcers, Levomekol, Tetracycline and Synthomycin ointments, and others are prescribed on the recommendation of a specialist.
Also, washing the ulcer with antiseptics is prescribed to clean it of pus and dead tissue; a solution of Furacilin, Chlorhexidine, a weak solution of potassium permanganate, etc. can be used. To heal the wound, Actovigin and Solcoseryl ointments are prescribed.
Another method conservative treatment– use of compression bandages. They help speed up wound healing, reduce swelling and normalize blood circulation in the legs.
Surgical
Surgical treatment is prescribed for more severe stages of the disease, when the wound has become deep. The doctor manually cleans the ulcer of dead tissue and pus and treats it with an antiseptic solution. Often purification from pus is carried out using the vacuum method, this allows you to quickly clean the wound and speed up its healing.
In especially advanced cases, when gangrene occurs, doctors amputate the limb. After any operation, a rehabilitation period begins, the patient is prescribed a series of medications, physiotherapy, massage and exercise therapy.
Folk
Many patients are interested in how to treat trophic ulcers with folk remedies, because it has long been known that this method of therapy is quite effective. But you should understand that with self-medication there is a risk of serious complications, so use folk remedies recommended after consultation with your doctor and complex treatment. Don't forget that recipes traditional medicine They perfectly relieve the symptoms of the disease, but they cannot eliminate its cause.
The following remedies help with trophic ulcers:
- Medicinal baths with herbs, for example, chamomile and sage, help well, but you need to make sure that there is no allergic reaction, otherwise severe dermatitis will appear.
- Cabbage leaf has a good anti-inflammatory effect. It is washed, beaten with a meat mallet and greased sea buckthorn oil. The leaf should be applied to the ulcer for the whole day, and in the evening a new one should be put on for the whole night. Repeat until the wound heals.
- Aloe vera is very popular among patients with trophic ulcers; it perfectly draws out pus and accelerates wound healing. For treatment, a leaf of a three-year-old plant is cut and the pulp is applied to the ulcer, secured with a bandage.
Prevention
Trophic ulcer is a very dangerous disease, it can provoke blood poisoning, gangrene, and in some cases the ulcer transforms into malignancy. For this reason, it is imperative to treat the disease and prevent it, following the following recommendations:
- It is necessary to promptly treat all diseases that are present in the body, to prevent an increase in sugar in diabetes.
- It is very important to take good care of your feet, treat wounds and wear comfortable shoes that do not pinch.
- You need to eat right, don't overindulge harmful products and avoid excess weight.
- It is important to strengthen general immunity, eat more vitamins.
Treatment of trophic ulcers with a feminine pad - (video)
Trophic ulcers are called violations of the integrity of the skin or mucous membrane, arising due to insufficient blood circulation of epithelial cells and their gradual death. They are located mainly on the legs (in the lower parts), but are also found in other places.
The main difference between such wounds on the legs is long-term healing, which in most cases is impossible without drug intervention. Often ulcers do not heal for more than 60 days, inflammation and swelling of the skin intensify every now and then and require prompt treatment. This material will tell you how to treat trophic ulcers of the lower extremities, their types and characteristics.
What it is?
A trophic ulcer of the lower extremity is a defect of the skin and mucous surface that appears after the destruction of surface tissues. Intense destruction can be triggered by impaired blood flow, infection and other factors. After which the patient develops a disease in the vessels that spreads, and as a result, treatment becomes difficult.
What distinguishes a trophic ulcer from other diseases is:
- long-term (up to 1 month or more) recurrent nature;
- the spread of the lesion not only over the surface of the skin, but also deep into the tissues down to the bones;
- loss of the ability to regenerate in the damaged area;
- healing occurs with the formation of a rough scar.
Timely treatment of a trophic ulcer leads to its scarring. However, no patient is immune from reappearance trophic ulcerations on the legs in the future.
Causes
According to statistics, symptoms of a trophic ulcer most often occur with a complicated course or. In this case, the cause of the disease is a violation of the outflow of venous blood from the underlying parts of the lower extremities - blood stagnation gradually develops in small-caliber veins, the regulation of the tone of the capillaries of the microcirculatory bed is disrupted, and the arterial link is the last to be affected vascular system. With atherosclerosis of the arteries, blood flow and, accordingly, the supply of oxygen and nutrients to the tissues below the location of the atherosclerotic plaque deteriorate.
The most common reasons occurrence of trophic ulcers:
- Thermal injuries - frostbite or burns;
- Diabetes mellitus and its complications;
- Chronic, including allergic;
- arteries of various calibers in the lower extremities;
- Chronic diseases of the veins of the lower extremities - varicose veins, thrombophlebitis and its consequences;
- Anatomical and inflammatory diseases lymphatic vessels– acute and chronic;
- Injuries to nerve trunks with subsequent violation of integrity;
- Autoimmune diseases of connective tissue, accompanied by systemic disturbances of blood flow in the arterial, microcirculatory and venous beds, including antiphospholipid syndrome.
Usually, in the formation of a trophic ulcer, two processes are of equal importance - the formation of pathological phenomena that affect the blood supply and innervation of a certain area of the skin and subcutaneous tissue (most often on the lower extremities) and trauma, which provokes primary damage at the site of formation of the future ulcer.
View photos
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Symptoms
The danger of the disease is that the symptoms that help diagnose a trophic ulcer appear suddenly. Still, there are signs in the form of swelling, heaviness and pain in the extremities, against the background of which symptoms arise, which determine the onset of development of a trophic ulcer.
The list of signs that indicate the possibility of the onset of the development of a trophic ulcer includes the main ones:
- Itching, heat and burning in areas of the skin.
- Cramps that occur during sleep.
- The appearance of the epidermis, which is accompanied by pain.
- The presence of purple spots that can reunite during growth.
- External changes in the skin: rough areas with a glossy surface appear.
The listed signs appear in the area where the veins are located, on the inside of the lower leg. This is due to the fact that the development of the disease begins precisely from the areas where the veins are located, where it manifests itself in the form of the formation of small ulcers. The shape of the ulcer resembles a volcano crater, with torn edges along the entire roundness, with possible suppuration at the ends, as a result of inflammatory processes. Damage to the arteries, namely they are primarily subject to inflammatory processes and destruction of integrity, is determined by the following signs:
- The appearance of small ulcers on the toes.
- Paleness of the epidermis.
Ulcers of a neurotrophic nature resemble bedsores in appearance, which have a rounded shape. Their location is most often the heel area or the sole of the foot. Inflammatory processes are sluggish and do not cause any particular pain. Autoimmune lesions are expressed in a symmetrical location on both limbs; in diabetes mellitus, ulcers appear on the heel and one of the toes.
Classification
Characteristic features of development different types trophic ulcers:
- Neurotrophic ulcers - have the shape of a deep crater;
- Pyogenic ulcers are shallow and oval in shape;
- Venous ulcers - night cramps, swelling and heaviness of the legs, violet/purple spots along the veins;
- Hypertensive ulcers (Martorella) - quite rare, symmetrical compactions slowly form on a red-bluish background;
- Diabetic ulcer - loss of sensitivity, night pain, no symptom of “intermittent claudication”, very deep wounds of a large area rapidly develop;
- Atherosclerotic ulcers - preceded by “intermittent claudication” (difficulty climbing stairs), constant coldness of the legs, increased pain at night.
Stages of ulcer development
Trophic ulcers form in several stages:
- The first stage of pathology formation. The patient has initial symptoms - red spots on the lower extremities, which intensively peel off. Gradually, the spots begin to provoke itching and discomfort.
- The second stage of pathology progression. Instead of red spots, the patient develops wounds that have a dark tint. On the surface of the wounds, ichor is visible, which slows down healing. The patient begins to complain of deterioration in health, elevated temperature body and fever. Intoxication can also be diagnosed.
- Third stage of defeat. The wounds begin to intensively secrete pus. The lesion increases in size and becomes regular in shape. The ulcers also progress deeper into the leg, causing severe pain. The patient experiences the emergence of new lesions.
If treatment is not started, this situation can provoke sepsis.
What does a trophic ulcer look like: photo
The photo below shows how the disease manifests itself in the initial and advanced stages.
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How to treat a trophic ulcer?
The earlier full-fledged (both local and systemic) treatment is started, the best result will be achieved, and the body will be at less risk. Shallow ulcerative skin defects in the initial stage are treated conservatively; surgical intervention in this case is not advisable.
How to treat trophic ulcers and what medications to use is decided only by a phlebologist. Self-conducted local treatment may result in the healing of a single ulcer, but does not exclude the appearance of new wounds. Only a local effect prescribed by a doctor and systemic therapy for the underlying disease will prevent the deepening of the ulcerative process and minimize the chances of relapse.
For an open, non-scarring wound, the following remedies are used:
- NSAIDs to relieve inflammation and soreness;
- Antibiotics - capsules, tablets, and in case of severe disease - intramuscular injections;
- Antihistamines - Suprastin, Xizal, Tavegil - to eliminate an allergic reaction;
- Drugs that reduce blood viscosity - antiplatelet agents - to prevent the formation of blood clots;
- Antiseptic solutions or medicinal herbs for daily washing of the ulcer.
When treating ulcers, Unna's bandage is often used. To do this, you need a gelatin-glycerin mixture with the addition of zinc and an elastic bandage.
- The bandage should be applied to the lower leg from the foot to the knee.
- The prepared mixture is applied to the skin, then wrapped in 1 layer of bandage, and re-covered with the mixture on top of the bandage. Do the same with other layers.
- After 10 minutes, the bandage should be lubricated with formaldehyde to remove stickiness.
- You can walk in 3 hours. After 1.5 months, the ulcers heal.
Among the ointments for treatment, it is necessary to use antiseptics, proteolytics and venotonics.
- The first include: Bioptin, Miramistin, Levomekol.
- To the second group: Iruksol and Protex - TM.
- The group of venotonics includes: Lawton, Hepatrombin and Hepton.
Gels are used to treat trophic ulcers local application based on heparin. The enzymes included in the gels are insignificant, so they do not cause allergies and side effects. The more heparin in the gel, the better effect. Such gels include:
- Lyoton;
- Trombless;
- Thrombophobe.
To start treatment with a patch, you need to prepare it:
- 20 g of combustible sulfur;
- two medium onions;
- 80 g wax;
- 20g spruce resin;
- 60 g butter.
Mix everything thoroughly to form one thick mass. Apply the mixture to linen fabric and apply to the sore spot, secure with a bandage. Remove after 2 days.
In addition, physiotherapeutic procedures will significantly increase the rate of healing of ulcers:
- Exposure to magnets dilates blood vessels and increases blood flow;
- Sunbathing (ultraviolet lamp);
- The method of treating an ulcer with ultrasonic cavitation operating at low frequencies has an antiseptic effect;
- Procedures in a pressure chamber give an excellent effect in the treatment of arterial wounds;
- Laser treatment of ulcers is a relatively new method that can significantly reduce pain;
- Ozone therapy cleanses the wound of bacteria and dead cells, saturates living tissues with oxygen, and is well tolerated by all patients.
- For full recovery Balneotherapy and mud therapy are recommended.
Compression bandages in the treatment of trophic ulcers
Elastic compression must be performed at all stages of treatment. Most often this is a bandage made of several layers elastic bandages limited stretchability, which must be changed daily. This type of compression is used for open ulcers of venous origin. Compression significantly reduces swelling and vein diameter, improves blood circulation in the lower extremities and the functioning of the lymphatic drainage system.
One of the progressive compression systems for the treatment of venous trophic ulcers is Saphena Med UCV. It uses a pair of elastic stockings instead of bandages. For the treatment of ulcers with varicose veins, permanent elastic compression using medical knitwear “Sigvaris” or “Medi”, compression class II or III, is recommended. To carry out intermittent compression for pyogenic, congestive and other types, you can use special compression bandages called “Unna boot” on a zinc-gelatin base or “Air Cast boot”.
Dressing and applying a compression bandage
Folk remedies
A list of some folk recipes that can additionally help in treating ulcers at home:
- This happened even before the revolution. A 6-year-old girl had ulcers and abscesses all over her legs. She lay and cried day and night. One day a passerby came into the hut, examined the wounds and told him what to do. You need to take 3 handfuls of dope and nettle and steam them in 5 liters of boiling water. Then dilute it with water in a barrel so that the water level reaches the girl’s groin. Keep the child in the warm broth for 30-40 minutes. The parents did just that, at first the girl screamed as if she had been dipped in boiling water. After the procedure, she fell asleep and slept peacefully for a day. For complete cure Three procedures were enough. (HLS 2004, No. 23, p. 30).
- Take 4 toasted hazel kernels and grind them into powder in a coffee grinder. Hard boil 2 eggs, remove the yolks, dry and grind them into powder in a hot frying pan (clean without fat). Mix and grind the yolks and kernels, add 1 coffee spoon of yellow iodoform powder. Clean the trophic ulcer from necrotic deposits with hydrogen peroxide, then apply a thin layer of the mixture, do not bandage for 1.5 hours. Then cover with a sterile napkin and bandage for two days. (HLS 2003, No. 6, p. 15, from a conversation with Clara Doronina).
- Cauterize a clean wound with alcohol tincture of propolis or regular vodka. And then apply Vishnevsky ointment, which contains Birch tar. Can be used ichthyol ointment, which has similar properties.
- A woman with diabetes mellitus developed trophic ulcers on her legs. For 4 months she hardly slept, experiencing either terrible pain or impossible itching. I visited many medical institutions and received treatment. by various means, which doctors prescribed to her, but the ulcers on her lower legs did not heal. A friend advised her to read the “Healthy Lifestyle Bulletin” and write folk recipes And Special attention pay attention to treatment with the ASD fraction. I decided to treat the ulcers with this remedy, as a result the pain stopped almost immediately, and after two weeks the ulcers began to heal. (2010, no. 13, pp. 22-23).
- Propolis ointment based on goose fat. Take 100 g of goose fat and 30 g of crushed propolis. Cook in a water bath for 15 minutes. Place the ointment into the ulcerated hole. Cover with compress paper and bandage. This ointment can be prepared using butter or internal pork fat.
- Once a patient was brought to the hospital from the medical and social care department on a stretcher; he had three trophic ulcers of the legs, he lived alone and suffered from alcoholism, looked like a homeless person, they washed him, began to treat him, his condition improved, but the wounds were not on his legs. The doctor who treated the patient found a method of treatment with solid oil in the literature. The man had his ulcers treated with hydrogen peroxide and bandaged with grease for two days. Gradually the wounds cleared and began to heal. The patient began to walk. (2008, no. 8, p. 19).
- Powder from dried tartar leaves. Wash the wound with a solution of rivanol. Sprinkle with prepared powder. Apply a bandage. In the morning next day Sprinkle with powder again, but do not wash the wound before. Soon the ulcer will begin to heal.
Treatment of diseases of the lower extremities with folk remedies is a long and labor-intensive process. Recovery occurs only with regular treatment of the affected areas of the skin, following a diet, the right image life. The folk remedies used must also be prescribed by the attending physician. Self-medication can lead to complications.
Surgery
If the condition is advanced or it is not possible to slow down the development of the ulcer, surgical interventions. In each case, an individual surgical plan is drawn up. But the general meaning of the intervention is this:
- Remove dead tissue;
- Provide maximum quick removal separated;
- Activate and create conditions for natural healing.
- In case of deep trophic ulcers on the toes and feet, they are amputated to prevent the development of gangrene and blood poisoning.
A separate group of interventions is elimination cosmetic defects, remaining after trophic ulcers. Healthy skin transplantation (for example, from the patient’s buttocks) and scar polishing can be performed.
Complications of trophic ulcers
As already mentioned, the ulcer itself is not terrible. Its complications are much worse. Among which:
- Gangrene.
- Sepsis (blood poisoning).
- Osteomyelitis (purulent lesion of the periosteum and bone).
- Death.
To prevent this from happening, trophic ulcers should be treated in a timely manner.
Prevention
It is easier to prevent any disease than to cure it; this is especially true for trophic ulcers. For prevention, it is recommended to closely monitor the condition of the veins, periodically apply gels and ointments that improve blood circulation, and avoid prolonged standing or sitting.
If circulatory problems are detected, you need to regularly perform physical therapy exercises and not neglect examinations by a doctor. It is also important to remember that self-medication can be harmful.
Trophic ulcer is a superficial defect of the integumentary tissues, which over time spreads to deeper tissues and has no tendency to heal. In most cases, trophic ulcers are formed as a result of malnutrition of a certain area of the skin or mucous membrane, lack of blood supply, or due to disturbances in the innervation of this area.
Trophic ulcers do not occur spontaneously. At the initial stages of the development of the pathological process, a bluish spot appears on the integumentary tissues of the affected area, which is accompanied by itching, burning and swelling and over time turns into a superficial wound, which tends to grow in depth and width instead of healing. A trophic ulcer is usually called any defect in the integumentary tissue that does not heal for more than eight weeks. Such ulcers are dangerous due to their complications, as they can lead to sepsis or even amputation of a limb. They should be treated promptly and under the close supervision of the attending physician.
The most common are trophic ulcers of the feet and legs. In approximately 70% of cases, these ulcers are caused by various pathologies venous circulation, such as varicose veins. In second place in terms of prevalence among the causes of trophic ulcers is obliterating atherosclerosis (approximately 8% of cases). Another important factor is the presence of diabetes mellitus in the patient, which leads to various defects of the integumentary tissue in approximately 3% of cases. Other causes may be thrombosis, trauma, disruption of innervation, etc. Severe complications trophic ulcers are accompanied in approximately 3.5% of cases.
The structure of the skin, its blood supply and innervation
Skin is a multifunctional organ covering the body of humans and many animals. It takes part in the thermoregulation of the body, performs a protective and barrier function, has the ability to breathe, absorb and excrete various substances. The skin is also an important component in the contact of the body with the environment, since it contains many receptors various types sensations such as pain or tactile. Skin is vital important body, damage to which can lead to serious consequences.The structure of the skin consists of three main layers, which in turn are divided into thinner layers:
1) The epidermis or outer layer of the skin is the thickest and most multi-layered part of the skin. The epidermis, in turn, consists of five thinner layers, arranged in a strict order, starting from the deepest to the most superficial:
- Basal layer
- Layer of spiny cells
- Granular layer
- Shiny layer
- Stratum corneum
2) The second layer in the structure of the skin is the dermis or the skin itself. It also consists of several types of cells, and in addition includes many elastic fibers and interstitial substance. In different areas human body The thickness of the dermis has different values. Thus, it can range in thickness from 0.5 mm to 5 mm. The dermis is divided into two main layers: papillary and reticular. The papillary layer is more superficial and is named so because it looks like peculiar papillae protruding into the epidermis. This layer is softer and more delicate than mesh. It consists of collagen and elastic fibers, as well as an amorphous structureless substance. The mesh layer is more compact and coarse-fiber. It is the main layer of the dermis, as it provides the skin with strength and elasticity. In addition to cells of various origins, the dermis is also rich in blood vessels and nerve endings.
3) The last and deepest layer of the skin is the hypodermis. It is also called subcutaneous fat. It consists of numerous bundles of connective tissue, between which there are fat cells closely adjacent to each other. The thickness of this layer varies widely depending on age, gender, constitution, type of nutrition and many other factors. This layer is a kind of energy reserve of the body and its thickness can vary significantly throughout life. The hypodermis also includes blood vessels of various sizes, nerve endings and nerves themselves, sweat glands and hair follicles. Also around the choroid plexuses and near the hair follicles you can find skin muscles that “raise” the hair under the influence of various stimuli, such as stress, cold, strong emotions, etc.
Blood supply to the skin is carried out thanks to a huge multi-loop network of arteries located under the hypodermis. Many smaller vessels depart from it, penetrating the skin and forming the so-called “superficial” choroid plexus between the papillary and reticular layers of the dermis. Skin capillaries form a complex and very dense network of vessels that supply nutrition to all skin cells. Capillary density varies between 15 and 70 capillaries per 1 mm 2 of skin.
Innervation of the skin is a rather complex system of receptors and nerve endings that perceive many different types of irritations. The skin is a huge receptor field involved in the formation of the sense of touch, heat or cold, pain, itching, burning, pressure and vibration, body position in space, etc. in the deep parts of the hypodermis, all these nerve endings form plexuses, from which larger nerves branch off, leading to the central nervous system.
Causes of trophic ulcer formation
The formation of a trophic ulcer is a chronic, slow process. The word "trophic" means nutrition, i.e. the very name of the disease indicates its origin. Regardless of the mechanism of development, the main link in the occurrence of a trophic ulcer is a local disturbance of cellular and tissue nutrition. It can be caused by various vascular, metabolic, blood or neurological disorders. | Cause | Mechanism of skin damage |
| Phlebeurysm | Varicose veins rank first among pathologies leading to the formation of trophic ulcers. When veins expand, the outflow of venous blood is significantly impaired, which leads to its stagnation at the site of expansion. This blood interferes with the flow of fresh arterial blood, which is rich in nutrients needed by the skin. Deoxygenated blood is not able to nourish cells and tissues, therefore, when it stagnates, the skin does not receive the elements it needs and, being for a long time under conditions of “starvation” it begins to gradually collapse, first forming superficial wounds that gradually turn into ulcers. |
| Vein thrombosis | Vein thrombosis is another common cause of the formation of trophic ulcers. Its mechanism is similar to that of varicose veins. When blood clots form, the lumen of the blood vessels narrows significantly, which interferes with the normal outflow of blood. Blood stagnation, in turn, prevents the flow of nutrients to nearby tissues. Prolonged lack of nutrition leads to the formation of trophic ulcers in these areas of the skin. |
| Atherosclerosis of the arteries | Atherosclerosis is the formation of fatty plaques on the walls of the arteries. Growing over a long period of time, these plaques can completely close the lumen of the blood vessel. This seriously impairs the flow of arterial blood to all tissues that receive blood from the blocked vessel. In these tissues various pathological processes such as ischemia and hypoxia. Over time, the skin in these areas becomes dry, thin, and gradually becomes covered with trophic ulcers. |
| Diabetic neuroangiopathy | Diabetes mellitus is endocrine disease associated with impaired glucose metabolism in the body. It is dangerous with many complications, one of which is disruption of the innervation and structure of blood vessels. With this disease, the walls of blood vessels become rigid, their structure changes, which leads to impaired circulation in the affected areas of the bloodstream. With a lack of arterial blood flow, trophic ulcers appear on the skin. Diabetes mellitus is also dangerous because the patient often does not feel pain in the area where the ulcer forms and does not notice it, which leads to a significant increase in the size and depth of the ulcer. |
| Infectious skin lesions | Various skin infections, combined with a local decrease in immunity and impaired skin nutrition, can lead to the formation of a trophic ulcer. This is due to the fact that some bacteria are capable of destroying skin cells and disrupting its structure. And recovery processes cannot compensate for this process due to poor circulation and lack of nutrients. |
Symptoms of trophic ulcers
The formation of a trophic ulcer develops in stages. Its symptoms can be divided into two large groups: early signs and late signs. Early signs include thinning and pallor of the skin, itching, burning, swelling, and muscle cramps. Later signs are bluish discoloration, dermatitis, superficial wound, purulent discharge or an unpleasant odor from the wound. However, the main symptom is the prolonged absence of recovery processes and the inability of the wound to heal.| Group | Symptom | Manifestation | Mechanism of occurrence |
| Early signs | Thinning and pale skin |  | The thinning of the skin is associated with a lack of “building material” brought by arterial blood, necessary for normal skin renewal. And pallor is a sure sign of the absence or lack of blood in the capillaries. |
| Itching |  | Itching is caused by irritation of nerve endings by various stimuli. Itching does not always indicate a pathological process, but if it is constant in the absence of any visible irritants (insect bite, contact with a plant or tissue, contact with the skin of any substance), this may indicate a local circulatory disorder. | |
| Burning |  | Burning is another signaling mechanism nervous system. Like itching, it can accompany the influence of various irritants on the skin, and also indicate pathological processes occurring in a given area of the skin. | |
| Swelling |  | The occurrence of edema is closely related to blood circulation, namely venous outflow. When the outflow of blood is disrupted and stagnation occurs in the venous bed, the fluid leaves the vessels and accumulates in the tissues, leading to edema. | |
| Local muscle cramps |  | With prolonged tissue hypoxia or disruption of the structure of the nerve endings innervating the muscles in the ischemic zone, spontaneous muscle contractions, called cramps, may occur. They are usually short-lived and painless, but this symptom should not be neglected. | |
| Late signs | bluish spot |  | Long-term oxygen starvation tissues leads to their destruction, which manifests itself in the form of a spot on the skin of a changed color - bluish or purple. |
| Dermatitis |  | Dermatitis is inflammatory process, occurring in the skin and caused by various factors. Most often, dermatitis indicates a local decrease in skin immunity that occurs when poor circulation. At the same time, bacteria living on the skin can trigger a chain of inflammatory reactions leading to tissue destruction. | |
| Superficial wound |  | The occurrence of superficial skin damage in the absence of obvious causes is a serious sign of impaired nutrition and regeneration processes of the skin area. For trophic ulcers main characteristic such wounds is their inability to heal. | |
| Purulent discharge and unpleasant odor from the wound |  | A putrid odor and purulent discharge from the ulcer indicate that it is infected and there are serious pathological changes, dangerous with many complications. |
Diagnosis of the causes of trophic ulcers
Diagnosis of the trophic ulcer itself is usually not difficult, since it superficial damage skin, which can be identified with a simple examination. It is much more important to establish the cause of a trophic ulcer, since its elimination is an important stage of treatment.| Group | Study | Methodology | results |
| Laboratory methods | Blood analysis |  | A complete blood count may show a significant increase in the number of red blood cells, which increases blood viscosity and can cause circulatory problems. Increased leukocytosis will indicate the presence of infection. Biochemical analysis blood tests are performed to identify risk factors such as increased cholesterol or glucose levels. |
| Bacteriological research |  | Bacteriological examination of a smear from an ulcer will help determine the presence and type of bacteria in order to select appropriate antibacterial treatment. | |
| Histological examination |  | Histological examination in the initial stages can indicate the degree of tissue hypoxia or damage to the microvasculature. In later stages this study is not informative. | |
| Rheumatic tests |  | Rheumatic tests indicate the presence of an autoimmune process that affects connective tissue. Often when autoimmune diseases the bloodstream is affected. The presence of indicators such as cryoglobulins and ANCA antibodies indicates a serious systemic disease, affecting the walls of blood vessels. | |
| Instrumental methods | Doppler ultrasound |  | Doppler ultrasound is the most common research method in the presence of trophic ulcers. Using ultrasound waves, blood flow is observed in the vessels located in the affected parts of the body. The method is very accessible, cheap, simple, non-invasive and quite informative. |
| MSCT angiography |  | MSCT angiography is special method computed tomography, aimed at a detailed study of the bloodstream. It helps to study in some detail the condition of blood vessels and identify any structural changes in the walls of arteries and veins that lead to poor circulation. | |
| MRI |  | Magnetic resonance imaging, like computed tomography, is an expensive, but very informative and useful diagnostic research method. This method is based on the physical phenomenon of magnetic resonance and helps to investigate the condition and function of various organs and tissues in the body. | |
| X-ray contrast angiography |  | With this method, a contrast agent is injected into the vessels under study, and its progress through the vessels is observed using X-rays. If the vessel has dilations, aneurysms, or, conversely, is narrowed or blocked, this method will certainly reveal such pathological changes. | |
| Laser flowmetry |  | Laser flowmetry is similar in methodology to Doppler ultrasound, but instead of ultrasound, a laser is used. This method It is distinguished by high accuracy, sensitivity and objectivity of results. It is used in the study of the microvasculature in order to identify the slightest circulatory disorders. |
Treatment of trophic ulcers
In the presence of a trophic ulcer, one of the main stages of treatment is to identify the cause of the disease. For this purpose, it is necessary to consult with doctors such as a phlebologist, dermatologist, endocrinologist, cardiologist, vascular surgeon or general practitioner. Late stages of the disease are usually treated in surgical hospitals. However, in addition to identifying and eliminating the cause of a trophic ulcer, it is also necessary not to forget about daily care of the affected area. | Group of drugs | Representatives | Mechanism of action | Mode of application |
| Angioprotectors and disaggregants | Acetylsalicylic acid; Pentoxifylline; Heparin; Prostaglandins | Angioprotectors and antiplatelet agents are aimed at correcting coagulation system disorders, systemically improving blood circulation and preventing blood stagnation in blood vessels. Disaggregants are called medications, affecting blood clotting and reducing the risk of blood clots. Angioprotectors are aimed at restoring and protecting the structure of the vascular wall, and may also have an antispasmodic effect. | Used in tablet form or intramuscularly intravenous injections. They have a systemic effect, affecting blood circulation throughout the body. |
| Antibacterial drugs | Levomycetin; Hexicon; Fusidine; Miramistin | These drugs contain an antibiotic or antiseptic that helps destroy bacterial cells in the wound. | These drugs are available in the form of an ointment or solution for topical use. They treat the ulcer directly, after which a special bandage is applied to reduce the risk of subsequent infection. The use of concentrated forms of antiseptics should be avoided. |
| Drugs that accelerate tissue regeneration | Sulfargin; Ebermin; Actovegin | These drugs affect metabolic processes in tissues, accelerating their recovery and improving their nutrition. | It is advisable to use drugs in this group topically in the form of ointment or cream. Such drugs are applied directly to the ulcers. |
Treatment of trophic ulcers: Proper toileting of a trophic ulcer begins with its cleansing and rinsing. For this purpose, a sterile saline. In later stages, dead tissue, secretions, and damaged tissue at the edges and base of the ulcer are surgically removed from the wound. After sanitation of a trophic ulcer, it is applied antibacterial drug or an ointment that accelerates tissue regeneration, and the ulcer itself is covered with a special bandage.
The choice of dressing depends on the degree of infection of the wound and the stage of its formation. If the wound is sterile and is at the healing stage, dressings are used to ensure adequate tissue hydration and breathing, protecting it from pathogenic bacteria or mechanical damage, as well as accelerating recovery processes in the wound. For an infected ulcer dressing should ensure constant absorption of secretions from the wound, have an antibacterial effect, stimulate the rejection of microorganisms and dead tissue from the ulcer.
In order to accelerate the healing of trophic ulcers, additional physiotherapy procedures are often resorted to, such as hyperbaric oxygenation, ultrasonic cavitation of wounds, ultraviolet radiation, magnetic therapy, laser therapy, etc.
| Name of physiotherapy procedure | Method of implementation | Effect |
| Hyperbaric oxygenation | In this procedure, the affected area of the skin is exposed to oxygen under high pressure. For this purpose, there are special chambers in which the pressure and concentration of oxygen are artificially regulated. | Hyperbaric oxygen therapy significantly reduces the resistance of microorganisms to antibacterial therapy, disrupts their vital functions, and also enriches tissues with oxygen. |
| Ultrasound cavitation of wounds | The wound is exposed to ultrasonic radiation generated by a special device. | Ultrasonic cavitation wounds leads to the destruction of microorganisms in the ulcer, significantly improves microcirculation, tissue regenerative abilities and has an anti-inflammatory effect. |
| UV irradiation | The affected area of skin is placed under a special lamp that emits ultraviolet rays. | UV irradiation is known for its antibacterial properties. In addition, it is capable of dilating blood vessels, improving blood circulation, increasing the body's resistance to various infections, and also activating the work of phagocytes - important participants in the inflammatory process. |
| Magnetotherapy | This method of therapy is based on the use of static magnetic field, affecting areas of the skin with trophic ulcers. | As a result of this procedure, blood vessels dilate, blood circulation improves, and swelling of the affected tissues disappears. Magnetic therapy also has an analgesic effect. |
| Laser therapy | The area of skin where a trophic ulcer has formed is exposed to laser radiation, controlled by a special device. | This type of therapy has analgesic, antispasmodic and anti-inflammatory effects. However, laser therapy should be performed under the close supervision of a competent doctor, as it can both cure and worsen the condition of the tissue. |
