Causes and complications of the ulcer

Causes are multiple, but the most common are vascular diseases, both venous and arterial, vasculitis related to an allergy or scleroderma, periarteria nodosa etc. . There may also be neurological and metabolic causes, such as complications of diabetes, but also various traumas either by pressure or irradiation, burns and even exposure to cold. Varicose ulcer is a consequence of and impaired microcirculation. Two categories of factors occur in this disorder: 1. Determined factors include: - Various varicose veins of various types that are formed in years and are based on excessive dilation, blood stagnating and thus occur as venous insufficiency of drainage, - Severe thrombophlebitis sequelae that can occur after fractures, .

- congenital dysplasia of lower limb veins due to congenital deficiency of deep vein valves. Factors favoring staging dermatitis and varicose ulcer include prolonged orthostatism, cardiovascular disorders such as: heart failure, endocrine diseases: hyperthyroidism, digestive diseases including: metabolic disorders: pulmonary and osteoarticular disease, and age also play an important role. The location of the varicose ulcer is predominantly in the internal maleoral region, but can be extended to other areas. Subjectively, the ulcer may be painful or painless, the pain succumbs to weakness and intensifies in advanced phases with inflammatory process present. Generally, the ulcer surface may be contaminated with germs as well as staphylococci.

If pain does not disappear when lifting the affected limb, you should also suspect an arterial component. Ulcers can be: single or multiple, with variable dimensions of a few centimeters (0. 5-1 or 15-20 cm), until the gang raises the manson. These may be superficial, but they do not pose therapeutic or profound problems, reaching up to aponeurosis, tendons, even with necrosis. The essential elements for diagnosis are: the bottom of the ulcer, the degree of infection, the presence and examination of the lesion margins.

All these elements should be followed at clinical consultation because they have a role and prognosis. Other manifestations that accompany the varicose ulcer are given by: - ​​which is one of the primary manifestations and is accentuated in orthostatism, is white, soft, warm and painless, disappearing after night sleep, - dermatitis ocra appears on the limbs of affected limbs either under . The investigations include both clinical methods including inspection and palpation, continued with various samples, and paraclinics include: by capturing ultrasounds reflected from the surface of a vessel and transforming it into a graphic and sound signal, with a major diagnostic significance. However, the most important investigation remains phlebography, which highlights venous tracts after injection of the contrast substance. Positive diagnosis is based on anamnesis, history of heredo-collateral and personal physiological and pathological history, after the clinical examination of apparatus and systems, including the evidence of the lesion with its typical description, followed by paraclinical investigations.

Differential diagnosis is performed primarily with arterial ulcers exhibiting similar symptoms, but typical is pain that is difficult to tolerate by patients with lymphatic ulcers, neuropathies with plantar and fingers, infectious episodes of various aetiologies, but also with . Treatment of venous ulcer aims to treat chronic venous insufficiency by: prolonged clamping, elastic stretching with elastic bandages applied in the morning before lifting from bed and being taken off at bedtime by surgical treatment, if necessary, and medication treatment including medication with action . Local treatment of the ulcer includes debriding the area and removing the necrosis area, excretion by applying compresses. Excision of scar tissue after a local anesthetic is useful to remove all adherent deposits and eliminate all localized infection. Finally, the application of local antibiotic powder treatment, scarring spray, to which is added oral treatment for 7-10 days in the case of those with multiple comorbidities.

The most common are mixed flora infections, followed by myeloid overgrowth in treatment, but also eczema, even haemorrhages in difficult cases. Evolution and prognosisThe rule does not exist in healing ulcers and depends greatly on the site of the lesion. The lesion is located on a bony plane, the healing is slower because the vascular bed is missing from the muscular capillaries. Healing time is generally between 40-60 days and requires interdisciplinary collaboration between specialties, but also a proper wound dressing at home. .