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Trophic ulcers of the lower extremities: symptoms and treatment, drugs, photos

Trophic ulcers on the legs are difficult to cure, and after healing often let them know about themselves again. Without the use of medicines, it is impossible to get rid of them, and in many cases such tissue damage leads to disability.


Trophic ulcers - what is it?

Trophic ulcers are damage to the skin, mucous membranes and subcutaneous tissues due to impaired lymph and blood circulation and insufficient supply of nutrients and oxygen. Characteristic of a prolonged course - the affected areas can not heal for 2-3 months and longer.

Localization of ulcers on the legs depends on the underlying pathology that provoked the appearance. With varicose veins and thrombophlebitis, they are located on the shins and ankles, with diabetes - on the feet.

Trophic ulcers of lower extremities

The main causes of trophic ulcers:

  • violation of lymph drainage;
  • venous congestion;
  • swelling due to fluid retention;
  • poor nutrition of the tissues of the legs.

The last two reasons are the consequence of the first two. The main diseases that can lead to trophic damage to the lower extremities are:

  1. Varicose veins and thrombophlebitis - disrupt the circulation of venous blood in the legs, worsening the trophism of tissues and destroying them. Ulcers are more often formed in the lower part of the lower leg.
  2. Diabetes mellitus is the cause of inflammation of the vascular walls, which leads to a malfunction of normal metabolism in tissues and their disintegration. Ulcerous lesions are localized in the area of ​​the feet - on the heels and fingers.
  3. Atherosclerosis - with the narrowing of the lumen of the vessels due to the sedimentation of cholesterol on their walls, the supply of nutrients and oxygen is also impaired. As a result, tissue necrosis develops - the trophic ulcers are symmetrically located on the anterior and posterior surface of the tibia.

Other causes and risk factors:

  • hypertension;
  • postthrombophlebitis;
  • thromboangiitis;
  • impaired innervation;
  • trauma, frostbite, burns;
  • allergic reactions;
  • constant wearing of tight and uncomfortable shoes.

A trophic ulcer is a lesion of the skin and subcutaneous tissue that does not heal within 1.5 months.

Symptoms of trophic ulcers on the legs, manifestation

Symptoms of trophic ulcers on the legs

Symptoms of trophic ulcers develop gradually, and not suddenly. The occurrence of ulcers is preceded by a strong dryness of skin areas on the foot or both extremities, not dropping puffiness, pigmentation and convulsions. The formation of a trophic wound proceeds in 4 stages:

  1. The first manifestation and the onset of progression.
  2. The stage of purification.
  3. Granulation of the center and scarring of the edges.
  4. Full granulation and scarring.

Consider the symptoms of trophic ulcers on the legs in stages of development.

The initial stage of trophic ulcers on the legs

The initial stage of trophic ulcer (photo) and treatment (healing)

The initial stage of trophic ulcer (photo) and treatment (healing)

The initial stage of the trophic ulcer

Against the background of the underlying disease, the permeability of the vascular walls rises, and the red blood cells go beyond it. Hemoglobin is converted to hemosiderin and, accumulating in the skin, provokes pigmentation.

This is the first stage in the development of a trophic ulcer on the leg. The initial stage is also manifested by thinning of the skin, which becomes shiny, like a lacquer. Progression complements the inflammation of subcutaneous fat and hyperemia of the skin of the limb.

Because of swelling, it is impossible to grab the skin with your fingers, and the accumulated liquid appears on the surface, forming a drop of moisture on it. Emerging light spots are zones of necrotic tissue.

Without treatment at this stage, a scab forming into the skin is formed, and then a red wound region is the trophic ulcer proper. The initial stage of trophic ulcers, depending on the severity of the development of varicose disease or other pathology, lasts from 3-4 hours to 4 weeks.

Cleansing of the ulcer

The trophic ulcer has rounded edges, and its appearance in the second stage depends on the presence of infection of the wound and the timeliness and effectiveness of the treatment. The affected area secretes mucus with pus, often with an admixture of blood and fibrin strands.

If there is an infection, the ulcer exudes an unpleasant, putrid smell and itches.

Additional signs of trophic ulcers (1-2 stages):

  • heaviness in the legs;
  • burning and soreness of the skin;
  • chills;
  • the perforation of the cyanotic vessels under the skin;
  • increase in temperature on the affected area;
  • exfoliation of the epidermis.

The third and fourth stages

The defeat goes to the third stage only in the case of treatment conducted at stage 2. Edges begin to heal, and cicatrization of the ulcer occurs in the direction from the periphery to the center - there appear areas of pink color.

  • The duration of stage 3 depends on the effectiveness of therapy, and on the size of the ulcer.

If the trophic (nutrition) of tissues is not completely restored, then the risk of a reverse transition to the initial stage is high. Final scarring occurs in the fourth stage - this may take up to several months. The ulcer is completely granulated and heals.

Treatment of trophic ulcers of lower extremities, preparations

Treatment of trophic ulcers of lower extremities

With trophic ulcers of the lower extremities, treatment with medicinal preparations is carried out separately or as an addition to the operative cleaning of the affected area. With an open, not yet cicatrizing wound, the following means are used:

  • Antibiotics - capsules, tablets, and in severe cases - injections intramuscularly;
  • NSAIDs for the removal of inflammation and soreness;
  • Drugs that reduce blood viscosity - antiplatelet agents - to prevent the formation of blood clots;
  • Antihistamines - Suprastin, Xizal, Tavegil - to eliminate allergic reaction;
  • Solutions of antiseptics or medicinal herbs for daily washing of ulcers.

When the trophic ulcer from the drugs prescribe antiseptic and antimicrobial ointments. They are thinly applied to bandage or gauze and tightly fixed on the leg.

Examples of means - Levosin, Levomekol. To combat bacterial infection, salt compresses are also used at a rate of 1 tsp. salt to 200 ml of water.

To treat trophic ulcers on the legs at the stage of granulation and scarring are shown such medicines:

  • Local healing agents - gels, creams or ointments - Solcoseryl, Actovegin;
  • Antioxidants - accelerate the removal of toxic substances from tissues;
  • Antiseptics.

With venous etiology, ulcers always use compression stockings, tights or elastic bandages that are worn constantly and changed every day. In addition to treating the skin lesion, therapy of the underlying pathology, which caused the development of trophic ulcers, is necessarily carried out.

Treatment of trophic ulcers of the lower extremities at home by folk remedies is considered as an addition to the basic therapy. Effectively washing the wound with freshly squeezed potato or cabbage juice, which can also be used to apply compresses.

For these purposes, also used decoction of oak and willow bark powder. From natural medicines in the treatment of trophic ulcers ointments with comfrey, geranium and arnica are effective.

From non-traditional methods the attending physician can appoint:

  • mud treatment;
  • laser therapy;
  • ultrasonic cavitation;
  • balneotherapy - mineral water treatment;
  • hirudotherapy - use of leeches to eliminate blood stasis and dissolve thrombi;
  • ultraviolet radiation;
  • ozonotherapy.

Surgical treatment is indicated if the conservative is ineffective. Ulcer during the operation is excised, necrotic areas of the skin and subcutaneous tissues are removed. Vacuuming and curettage are used to eliminate mucopurulent content.

Limb amputation is used in neglected cases, when there is no other way to save a person's life.


The danger of trophic ulcers is their complications, such as:

Without proper and timely treatment, the trophic ulcer on the leg has an unfavorable prognosis - the result is a limb loss, and without seeking medical help - a fatal outcome due to the development of dangerous complications.


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