Surgery diseases >>>> What is a trophic ulcer?

What is a trophic ulcer?

An ulcer is a deep defect in the skin or mucous membrane resulting from chronic inflammation caused by infection, trauma, thermal, chemical or radiation burns, resulting from impaired innervation and blood supply. The process of ulcer formation is similar to the necrotic process, when tissue death occurs, but unlike gangrene, tissue necrosis in an ulcer takes place in a slow mode. A characteristic feature of the ulcer is the absence of a tissue site in the place of its development and prolonged non-healing. The process of tissue regeneration at the site of the ulcer occurs through the formation of connective tissue (scar), replacing the missing section of the epithelium or mucous membrane.

A trophic ulcer is a sign of the disease, and it appears as a complication of diseases associated with a violation of tissue trophism (malnutrition of tissues due to impaired metabolic processes, arterial or venous blood supply to tissue sites) and leading to a decrease in reparative processes against a background of reduced immunity. Diabetes mellitus, anemia, vitamin deficiency, atherosclerosis, alimentary dystrophy, varicose veins, thrombophlebitis, diffuse connective tissue diseases, nonspecific and specific chronic infections, impaired lymph flow, bedsores, chronic skin diseases can cause trophic ulcers.

Diagnostics of a trophic ulcer is a multifaceted process, where special attention is paid to blood sugar tests, bacteriological diagnostics, cytological studies, instrumental examination of the vessels of the extremities (Doppler ultrasonography, thermography, angiography, rheovasography).

Trophic ulcers do not heal on their own, since they require elimination of the cause that caused it. Therefore, the treatment of trophic ulcers is based, first of all, on the treatment of the disease that provoked its appearance.

Local treatment of trophic ulcers is based on the removal of necrotic plaque using proteolytic enzymes, treatment of tissues adjacent to the ulcer with antiseptics (a weak solution of furacilin or potassium permanganate). Apply special absorbent dressings, ointments (levomikol and others of similar action). Solcoseryl, Actovegin are used to speed up regenerative processes. Biofilms are used to protect the wound surface from infection.

General therapeutic treatment of trophic ulcers includes broad-spectrum antibacterial agents, antiplatelet and anti-inflammatory drugs, desensitizing drugs, immunostimulating drugs.

Treatment of a trophic ulcer also requires the participation of a vascular surgeon, who will restore arterial or venous circulation in the places of its location. With a properly designed treatment that takes into account all the causes of a trophic ulcer, it cicatrizes, but with inadequate treatment, the prognosis may turn out to be unfavorable: gangrene and amputation. Therefore, it is not recommended to treat a trophic ulcer with folk methods, but should be observed by a specialist.