What antiseptic is effective for the treatment of trophic ulcers. Trophic ulcers of the lower extremities

For the treatment of wound formations of a trophic type that have arisen in a patient on the lower extremities or other parts of the body, drugs belonging to the category of antibacterial are used. They are used in cases where an infection has entered the open wound surface and an acute inflammatory process has begun, threatening the health of the patient and preventing further healing of the ulcer. In most cases, without the timely inclusion of antibiotics in the therapeutic course, it is impossible to carry out further effective treatment. Antibacterial medicines are produced in tablet form, or in the form of injections for intramuscular injection.

How and how to treat a trophic ulcer - antibiotics and other effective drugs, as well as devices

The current pharmaceutical industry provides a large selection of various broad-spectrum antibacterial drugs. This makes it possible to choose a drug for the treatment of trophic formations of any severity and taking into account the individual characteristics of the patient's body. Consider the most effective means that will help restore the integrity of the lower limb and maximize the healing of destroyed epithelial tissues.

ASD 1, 2 and 3 fraction for trophic ulcers

This type of antiseptic preparation was invented back in 1943 and is still actively used in the treatment of extensive trophic ulcers. The medicine has a healing and anti-inflammatory effect. It stands for "Dorogov's antiseptic stimulator". All three ASD fractions (1, 2 and 3) can be used in pure form for washing the wound, or diluted with saline. This is already determined by the attending physician based on how severe the disease is in the lower limb. The course of treatment is from 15 to 30 days. Treatment of the ulcer is performed 2-3 times a day. If the restoration of damaged tissues occurred earlier, then the use of ASD is stopped.

Akriderm

It is a combined medicine for external use. It has a transparent appearance without a pronounced color and odor. Akriderm gel is applied directly to the open area of ​​the wound with uniform spreading over its entire surface. This tool belongs to the group of glucocorticosteroids, so the use of Akriderm lasts no more than 15 days. Then you need to take a break of the same duration and you can start therapy again. The cream-gel is applied 2 times a day - in the morning and in the evening.

The drug has anti-inflammatory, antiseptic and. It perfectly relieves itching caused by the release of lymphatic fluid from the wound and eliminates the symptoms of excessive swelling of the leg. This medication contains synthetic hormones and should not be taken by children or women who are pregnant or breastfeeding.

Actovegin

Produced in ampoules for introduction into the patient's body in the form of intramuscular injections. The main purpose of this antibacterial agent is the destruction of a pathogenic infection, as well as the stimulation of damaged areas of the epithelium of the lower limb for more accelerated regeneration. After the inclusion of this drug in the general therapeutic course, patients begin to better absorb glucose and other useful substances involved in the division of epithelial cells. It also improves blood circulation throughout the body, which is extremely important for the normal outflow of venous blood from the leg area, where the pathological process of inflammation occurs.

The first positive results are recorded already 4-6 hours after the injection. The drug is not prescribed for people with diabetes, pregnant women, children and breastfeeding.

Apparatus Almag

A special device that works on the principle of generating electromagnetic impulses that affect the tone of muscle fibers and the quality of blood circulation in tissues. The principle of operation of the Almag device is that the patient attaches a belt with special metal plates to the diseased area of ​​​​the leg, but not to the open surface of the wound itself. After that, the device turns on and begins to exert a physiotherapeutic effect with a low-frequency, low-intensity pulsed magnetic field, which has a positive effect on trophism in the lower limb, relieves swelling, and improves venous blood outflow. In order to have positive results in treatment, it is necessary to use the Almag device daily with a duration of one session of at least 15-20 minutes. Longer therapy is contraindicated, so that there is no opening of bleeding.

Amoxicillin

Amoxicillin contains an antibacterial substance of the penicillin series, which is effective against most pathogens. If an infectious infection of a trophic ulcer has occurred, then the daily intake of Amoxicillin tablets allows you to completely eliminate the activity of pathogenic microflora and remove the development of even the most acute inflammatory process.

Treatment continues for 5-15 days. Longer antibiotic use is not recommended. If during this period there is no improvement in the clinical picture, then there may be indications for the use of more radical methods of therapy. Every day the patient should drink 1-2 tablets 2-3 times a day.

Argosulfan

The active substance sulfathiazole, which is part of this antibiotic, inhibits the growth of microbes that are in the open wound surface of the trophic type. The principle of action of this drug is such that the para-aminobenzoic acid contained in sulfathiazole blocks the synthesis of protein compounds in the cells of infectious microorganisms. In this regard, bacteria cannot perform their division and, ultimately, a decrease in the growth of pathogenic microflora occurs. Therefore, the cells of the immune system receive additional support and destroy the weakened infection.

This is how the trophic ulcer is cleansed of bacterial microorganisms, which previously were the cause of the inflammatory and purulent process. Argosulfan is considered a potent drug, so the dosage is determined individually by the attending physician. This also applies to the timing of therapy.

Acerbin

It has antiseptic, analgesic and healing properties. The intake of this remedy provides a decrease in swelling of the limb and prevents the accumulation of purulent exudate directly in the wound itself. Under the influence of Acerbine, the epithelial surface of a trophic type ulcer becomes covered with a crust and the first signs of healing begin to appear. This ointment is completely safe for the human body, as it is based on salicylic and malic acids, which not only provide suppression of bacterial infection, but also assist in the healing of the skin surface. The drug is applied to the affected area of ​​the leg 2 times a day. The ointment is smeared on the lower limb so that it covers not only the destroyed area of ​​the skin, but also the surrounding tissues, which have pronounced signs of inflammation.

Baneocin Powder

A combined broad-spectrum antibiotic that is active against most gram-positive and gram-negative microbes known to science. It is considered a polypeptide drug that affects even such dangerous infectious strains as Staphylococcus aureus and streptococcal infection. Microorganisms with natural resistance to Baneocin are extremely rarely recorded. The drug in the form of a powder is used after it is diluted with saline.

The therapeutic application itself is based on daily washing of the wound using an antiseptic and a sterile cotton swab. The main pharmacological action of the drug is the removal of inflammation of the trophic ulcer of an infectious nature of origin.

Betadine

Branolind N

This is a specific type of antibacterial drug, as it is produced in the form of a mesh dressing made of high quality textile fabric. The dressing material itself is richly impregnated with antiseptic solutions, which, upon contact with the wound surface of the sore leg, penetrate into the destroyed tissues and begin to show their therapeutic effect. The use of Branolind H dressings is very convenient, simple and affordable. It is enough just to carry out the primary treatment of the ulcer to cleanse it of exudate secretions, and then bandage the painful area of ​​the lower limb.

The bandage is fixed directly on the open wound so that the fabric fits as tightly as possible to the leg, does not hang out or twist. Replacing the dressing material Branolind N is performed 1 time in 2-3 days. Medicinal properties are to relieve inflammation, swelling and pain.

Vinylin

In medical terminology, it is also found under the name - "Shostakovsky's Balm". It is polyvinyl butyl ether, which has antimicrobial, enveloping and anti-inflammatory effects. After its application to the leg ulcer, the affected tissues are evenly covered with a thick and viscous substance, which does not allow the infection to further penetrate into the patient's body. At the same time, the chemical components of the drug carry out the destruction of the infection, which has already managed to get into the tissues of the lower limb.

The healing property of Vinilin makes it possible to achieve an excellent therapeutic effect and prevent the appearance of scars at the site of localization of wound formations. The terms of use of the medication are not limited and the treatment is carried out until the leg is completely healed.

Hydrogel

An innovative wound healing agent, which is highly effective in the treatment of trophic formations that have developed on the limbs due to the presence of certain pathological factors. The composition of this medication contains the substance polyvinylpyrrolidone and polyguanidine hydrochloride, which reduce the toxicity of infectious microflora and destroy their cell membrane. As a result of this, the bacteria already present in the wound die, and new microorganisms are not formed under the influence of the pharmacological properties of the drug. The hydrogel is produced in convenient plastic jars, and the principle of its use is that the patient applies the medicine evenly over the entire area of ​​the ulcer. The timing of therapy directly depends on the severity of the disease and the extent of the wound lesion of the leg.

Apparatus Darsonval

Physiotherapy device, the first prototype of which was invented in the middle of the 19th century by the French physicist Arcene. The device consists of a generator, electrodes and a transformer. Treatment with this apparatus consists in the fact that the circumferential surface of the skin, located in close proximity to the trophic ulcer, is subjected to shocks of weak electric current. For a person, they are completely safe and do not cause any pain, but their methodical effect leads to the fact that this area of ​​the skin and muscle fibers of the leg experience a state of real stress, because the presence of even small electrical impulses in the human body is a deviation from normal physiology. After the brain receives a signal about the presence of current in the region of the lower limb, certain of its centers send a response neural impulse, which gives the command to speed up the process of regeneration of epithelial tissues in case they are damaged by current.

In this regard, the healing of a trophic wound occurs much faster than usual.

Derinat

It is an immune system stimulant that has a modulating effect not only on the cells responsible for the implementation of the protective function of the body, but also stimulates the division of new cellular material. There is an optimization of the inflammatory process with the gradual onset of the remission stage. Thanks to the stimulation of the immune system, the body's response to bacterial and viral agents that enter the trophic ulcer from the environment is enhanced.

By itself, the drug does not have the ability to exterminate the infection, but it contributes to its destruction by improving the functioning of the immune system. If the wound formation on the leg is at the 1st or 2nd stage of its development, then taking Derinat allows you to avoid antibiotic therapy and cure the disease with a more gentle type of medication.

Detralex

One of the most effective drugs that are prescribed to patients suffering from trophic lesions of the lower extremities. This medicine is available in the form of capsules, which are taken 2-3 times a day. The course of treatment lasts from 15 to 30 days. This tool does not belong to the category of antibacterial or anti-inflammatory. The pharmacological property of Detralex is that its active components dilute too thick venous blood, improve its outflow, and prevent the development of thrombophlebitis. The absence of constant exposure to excess volume of lymph and blood makes it possible to eliminate the pathological factor itself, which provoked the appearance of a wound on the leg.

Diclofenac

The full name of the drug sounds like Diclofenac sodium. It is an anti-inflammatory and analgesic agent with a wide range of applications. It is used to relieve pain and acute inflammation in all parts of the body. Trophic formations in this case are no exception. In pharmacies, Diclofenac is sold in tablet and injectable form. To prescribe intramuscular injections to the patient or to prescribe tablets, is determined exclusively by the attending physician, the surgeon, or the phlebologist. This medication is suitable for the symptomatic treatment of trophic-type wound formations in combination with other drugs.

Dimexide

Anti-inflammatory and antiseptic solution. It does not have a pronounced color, but has a specific smell that resembles garlic extract. In the treatment of trophic skin lesions, it is used as the basis for compresses. In order to carry out therapeutic manipulations with the use of this drug, it is necessary to moisten a piece of sterile bandage or cotton wool with a solution of Dimexide, and then fix it directly on the surface of the ulcer.

In order for the compress to keep well on the leg, it can be fixed with a medical plaster or additional bandage. The use of this therapeutic agent is contraindicated in patients prone to manifestation, since Dimexide has a high potential to provoke local or general allergies.

Dioxidine

One of the strongest antibacterial drugs that is used to combat the most dangerous infectious strains. The therapeutic properties of the Dioxidine solution are based on the activity of its components, which, upon contact with foreign biological agents located in the wound surface, enter into a biochemical reaction and the destruction of pathogens occurs. This drug is effective against Proteus vulgaris, all types, Pseudomonas aeruginosa, anaerobic bacteria, pathogens of gas gangrene, which is very important in such a disease as a trophic leg ulcer. Dioxidin is used for no longer than 10 days, so as not to cause a stable addiction of microbes to the drug. Treatment consists in the fact that the patient independently, or with the help of medical personnel, performs washing of the diseased area of ​​\u200b\u200bthe leg with this antiseptic 1-2 times a day.

Iruxol

This remedy for the treatment of trophic formations belongs to the group of antimicrobial drugs. Produced by the manufacturer in the form of an ointment, which in its composition contains a complex of enzymes that ensure the cleansing of the wound from necrotic elements, the release of exudate, pus and other decomposition products of the affected area of ​​the lower limb. Regular use of Iruksol ointment allows you to effectively fight the growth of infectious microorganisms and prevents their further spread through the blood to other parts of the human body. By its properties, the drug is actually an antibiotic, but only in the form of an ointment. It is worth noting that this drug does not contain water in its composition and therefore has a thick enveloping structure. After Iruxol is applied to the wound, the lymphatic fluid is blocked.

Iodinol

A more advanced antiseptic solution based on potassium iodide. The treatment of a trophic ulcer is carried out according to the same principle as its lubrication with brilliant green or. It is necessary to apply a small amount of Iodinol on a sterile cotton swab, and then carefully lubricate the open wound. This method of treatment is quite painful, since the composition of the drug includes ethyl alcohol. There may be a burning sensation and pain. Iodinol is used as part of complex therapy or for symptomatic treatment, when ulcerative formation is just beginning to develop and has not acquired large-scale dimensions. In order not to provoke a chemical burn of the skin and open epithelial tissues, the wound should be treated with a solution of potassium iodide no more than 2-3 times a week.

Yodopirone

It is used for antibacterial disinfection of wounds. According to its pharmacological form of release, it is a solution. In order to carry out a therapeutic manipulation, it is necessary to apply a small amount of Iodopiron directly to the wound and wait about 5-10 minutes until the product is absorbed and dried. After the specified time, the first positive therapeutic effect occurs and most of the microorganisms that were in the affected area of ​​the skin and provoked infectious inflammation die. The disadvantage of this medication is that if other drugs of the antibacterial spectrum of action are not treated, then soon the pathogenic microflora again affects the wound. Therefore, simultaneously with the treatment of the ulcer with Iodopyrone, other medicines should be taken, which also have a wound healing effect.

Curiosin

Antibacterial and anti-inflammatory gel for external application to the surface of the affected area of ​​the epithelium. The drug has no pronounced odor and is completely colorless. After treatment of the ulcer, the active components of the agent are quickly absorbed into the tissues of the limb, so the application of additional dressings is not required. Curiosin gel is used at least 2 times a day. It is desirable that the interval between treatments is at least 12 hours. It is best to treat the wound in the morning and evening. Suitable for symptomatic therapy of trophic formations, and also perfectly integrated into the complex treatment course. Contraindicated in children under 14 years of age.

Lomfloks

Produced in the form of tablets. The composition of one Lomflox capsule contains the active substance lomefloxacin hydrochloride weighing 400 mg. It is used for the treatment of infectious and inflammatory processes in ulcerative formations of varying severity. The drug has proven itself in the fight against the most resistant strains of streptococcal infection and pneumococci. This type of antibiotic is considered quite potent, so the dosage is determined individually by the attending physician. It is very important to choose the correct average daily dose so that there is a therapeutic effect, wound healing and at the same time the microflora does not get used to the effect of an antibacterial drug on it.

Methuracol

A special therapeutic agent for more accelerated healing of wound surfaces that have all the signs of a trophic lesion. Meturacol is a plate that is impregnated with methyluracil ointment. Its concentration in one plate is so high that one piece of the drug can be used for 1-2 days without removing it. This will have a positive therapeutic effect on ulcer formation. It is enough just to attach the plate to the wound and fix it with a band-aid. As soon as the active components of the drug penetrate into the epithelial tissues, the process of stabilizing the nucleic metabolism will begin, the process of cell division will accelerate in tissues that previously had signs of infectious and inflammatory damage. In addition, Methuracol has a sponge-like effect on the wound and absorbs the secretions of lymphatic fluid.

Miramistin

An antiseptic solution, the action of which is based on the fact that the drug molecules interact with the lipids of microbial cell membranes, which ultimately leads to their fragmentation and further destruction. In a short period of time, almost the entire population of pathogenic microflora dies, which in one way or another got into a trophic type ulcer and provoked suppuration. The effectiveness of Miramistin lies in the fact that it does not violate the integrity of human epithelial cells. This aspect is very important for the fastest healing of the wound, starting with scarring of its edges.

It is necessary to wash the painful area of ​​\u200b\u200bthe limb or any other part of the body with a solution in the morning and evening.

Olazol

It is considered a combined drug that simultaneously anesthetizes pain in the area of ​​trophic ulcer formation, has an antibacterial, anti-inflammatory effect, and also reduces the release of exudate. The last property of Olazol is achieved due to the fact that the drug improves the local circulation of lymph and venous blood, preventing congestion in the limb. With the systematic use of the drug, after the stabilization of the patient's state of health, the process of regeneration of previously damaged tissues begins with their systematic healing.

Oflomelide

An ointment that has antimicrobial properties. Belongs to the category of medicines fluoroquinolones. The bactericidal effect on the wound surface of the limb is due to the fact that the active substances that make up Oflomelide block the process of transferring DNA information in bacterial cells. In this regard, the division of pathogenic microorganisms is completely stopped and the patient soon begins to feel much better. Signs of inflammation in the tissues of the ulcer gradually fade away, redness, itching and pain disappear. If there is an accumulation of pus in the affected area of ​​\u200b\u200bthe leg, then Oflomelid ointment ensures its evacuation beyond the lower limb. It is applied directly to the wound without the use of additional dressings. The frequency of application of the ointment is determined by the surgeon or phlebologist.

Panthenol spray

This medication can rightfully be classified as the most effective means to combat the inflammatory process in trophic type wounds. Treatment of painful tissues is performed by spraying directly onto the surface of the ulcer, which should eventually be covered with a uniform layer of white drug substance with a foam-like structure. The terms of treatment are no more than 5 days, and the therapy itself is aimed at ensuring the relief of acute inflammation in the shortest possible period of time. Panthenol is applied once a day.

Prontosan gel

Carries out a thorough cleaning of the wound surface from the presence of excess lymph and purulent exudate in it. After that, the healing of a trophic ulcer is accelerated by 2-3 times, since nothing inside the most damaged area of ​​​​the epithelial tissue provokes inflammation. In addition, Prontosan gel provides wound coverage with a thin film layer. This factor has the effect of preventing the entry of additional pathogens. In parallel with this, there is a suppression of the activity of microflora. The drug is suitable for the treatment of the consequences of trophic damage to the limb and can be used as a prophylactic agent.

Proteox TM

Medical fabric coating, which is sterile and impregnated with medicinal components - trypsin and mexidol. Designed for gentle cleansing of the wound from pus, relieves acute and chronic inflammation, stimulates faster healing, and also prevents tissue necrosis. This property of this drug is especially useful in violation of the trophism of the lower extremities, as it minimizes the risk of developing local blood poisoning in the form of gas gangrene with the risk of further amputation of the limb. The course of treatment consists of applying 3 to 10 tissue coverings to the wound. One dressing of Proteox TM is worn from 24 to 48 hours, and then it is scheduled to be replaced.

Napkins

This is a separate category of antibacterial and anti-inflammatory drugs that are used to treat trophic ulcers on the same principle as antiseptic dressings. It is necessary to attach a napkin to the surface of the diseased area of ​​\u200b\u200bthe leg so that it fits as tightly as possible to the skin. After that, the active effect of the medicines with which the napkin is impregnated begins on the pathogenic microflora present in the wound. One napkin is changed every 2-3 days, and with excessive secretions of lymphatic fluid, they are replaced daily.

Solcoseryl

Wound healing agent, which is prescribed for the treatment of obliterating pathologies of the blood vessels of the lower extremities, chronic venous insufficiency, trophic skin lesions. The pharmacological form of release of the drug is jelly, ointment, tablets, intramuscular and intravenous injections. What type of medication to choose for the treatment of the patient is determined by the attending physician based on the state of health of the affected limb. Solcoseryl is not an antibiotic, but has excellent ability to heal wounds by stimulating epithelial cells to their more accelerated division.

Stellanin PEG

The mechanism of action of the drug from the side of pharmacology is that the active substance diethylbenzimidazolium, which is part of the Stellanin ointment, inactivates the protein compounds of infectious microorganisms, preventing their further reproduction. Due to this effect, already after 2-3 days, the bacterial infection of the wound passes from the acute phase to the stage of stable remission, and the accumulation of purulent exudate stops directly in the epithelial tissues themselves. The exclusion of these pathological factors allows you to accelerate the healing process of damaged areas of the skin of the leg. The drug is designed for external use and is applied to the ulcer 1-2 times a day during the period of treatment, which is determined by the doctor.

Streptomycin

Antibacterial agent, which is available in the form of a white powder without a pronounced odor. In order to carry out antiseptic treatment of the wound surface of the trophic type, it is necessary to dilute 5 grams of Streptomycin in the same amount of physical solution. To prepare the medicine, the wound is washed by direct exposure of the medicine to the tissues of the diseased skin area, or using a sterile cotton swab. If it is not possible to mix Streptomycin with saline, then you can sprinkle the ulcer directly with the powder itself.

The medicine has not only an antimicrobial effect, but also dries up inflamed tissues, prevents excessive lymph secretion.

streptocide

A drug that allows for a short period of time to suppress the activity of pathogenic microflora that has entered the destroyed tissues of the lower limb. Wound treatment is performed according to the same principle as in the case of Streptomycin. You can dilute Streptocide powder with saline in proportions of 1 to 1, or apply it dry. The drug is most effective in combating such types of microbes as streptococcal infection, Staphylococcus aureus and all pneumococcal genotypes, which are one of the most dangerous types of infections.

Tetracycline

Ointment for external use, with the help of which the affected areas of the skin of the leg are treated. You can apply the drug to an open wound and within 10 minutes the active components of the drug are completely absorbed into the tissues of the lower limb. Tetracycline is an antibiotic that has been put into pharmacological formulation as an ointment. The duration of treatment lasts no longer than 10 days. Longer use of an antibacterial agent can provoke the addiction of bacteria to the chemical formula of the ointment and the development of acquired immunity in them. Treatment of trophic ulcers is performed in the morning and evening. The first positive therapeutic results are already visible on the 2nd-3rd day of using Tetracycline.

Triderm

The cream, which contains the main active substance of the antibacterial spectrum of action - gentamicin. Due to this, Triderm is active against most anaerobic, gram-positive and gram-negative microbes known to science. The therapeutic effect of the use of the drug is achieved due to the fact that gentamicin inhibits protein synthesis inside the cells of the infectious microorganisms themselves. Without the presence of this component, further construction of bacterial colonies is impossible and the mass death of pathogenic microflora begins. After 3-5 days of treatment of the wound with Triderm cream, there is a complete cleaning of the tissues from purulent exudate and a decrease in the severity of the inflammatory process.

Trypsin solution

Endogenous antiseptic solution based on proteolytic enzymes. After this drug enters the surface of an infected wound, the protein fibers of the bacterial infection are split into fractions. For pathogens, this means methodical death. Trypsin is a completely natural remedy, as it is extracted from the enzymes of the pancreas of cattle. This allows you to use the drug even for patients with an increased tendency to skin allergic reactions.

Trichopolum

Tricillin

Injectable antibiotic, which is administered to the patient intramuscularly. It is effective in the treatment of infectious inflammation of open wounds of the trophic type, the infection of which has occurred with bacteria sensitive to antibacterial drugs of the penicillin series. The duration of therapy is from 7 to 12 days and depends on how positive the dynamics of recovery will be. Tricillin is best used in combination with other wound healing agents, which in addition also stimulate cell regeneration.

Phlebodia

It is not an antibiotic, but is intended for the treatment and prevention of stagnant processes of the lymphatic fluid, as well as venous blood, which occur in the lower extremities. The drug is produced in the form of capsules and is taken daily according to the doctor's prescription. The terms of therapy are also formed by the doctor who sees the patient. On average, one treatment course lasts at least 15 days, but can be extended up to several months, since this remedy is not addictive, but only stimulates more enhanced local blood circulation. Due to this, the state of the trophic ulcer is also stabilized, which makes it possible to begin the process of its healing.

Fukortsin

In the pharmacy, this medicine can still be found under the name "Castellani Paint". This is an antiseptic solution that has a bright crimson color. Effective against most bacterial and fungal microorganisms. Treatment of the wound area of ​​the lower limb is carried out by applying a small amount of the drug to a sterile cotton swab with further cleansing of damaged tissues from exudate and other products of purulent inflammation. The drug is not recommended for the treatment of pregnant women.

Furazolidone

This is an antibiotic that the manufacturer produces in the form of light yellow tablets. In the treatment of trophic neoplasms, Furazolidone is not taken orally, like most tablet medicines, but it is preliminarily dissolved with the preparation of an antimicrobial solution. To do this, you need to take 1-2 tablets of Furazolidone and dissolve them in 250 grams of warm water until the crystals completely disappear at the bottom. After preparing the medicine, you can wash the ulcer.

Chymotrypsin

Powder of white color which is intended for preparation of intramuscular injections. In order for the drug to be ready for full use, it must be diluted with a physical solution. The pharmacological properties of the drug are its anti-inflammatory effect. Especially effective remedy for deep vein thrombosis and inflammation of their walls. If a patient has a trophic ulcer, injections of chymotrypsin can relieve swelling, stop the accumulation of pus and improve local blood circulation.

eplan

Available in the form of droppers for intravenous installation, as well as in the form of a cream for external use. The drug can be safely classified as a universal remedy designed to combat trophic ulcers of varying severity, since this medication simultaneously has analgesic, antimicrobial, regenerating and anti-inflammatory properties. The best therapeutic effect is recorded in cases where Eplan is used in the form of droppers at the same time and ointment is applied in parallel to the wound surface.

Epler

Natural antiseptic, which is made from therapeutic mud, algae and bottom sediments of fresh lakes located in Western Siberia. The pharmacological form of the drug is a solution with which direct wound washing is performed. You can also do anti-inflammatory compresses. To do this, you just need to abundantly moisten a piece of gauze tissue with Epler's solution and fix it on the surface of the trophic ulcer for 2-3 hours. A positive therapeutic effect occurs already on the 4th-5th day of using the Eplir solution.

A trophic ulcer is not considered a separate disease, rather, it is a complication against the background of erysipelas, lymphoderma, diabetes, frostbite, burns, non-healing wounds for a long time. With an ulcer, under the influence of the inflammatory process, tissues and cells begin to necrotize the ulcer, which inevitably leads to disability.

It is necessary to treat pathology taking into account the type of disease and the stage of development. Usually ulcers affect the legs and lower limbs, gradually growing and merging into one large purulent and bleeding wound. Ointments for the treatment of trophic ulcers on the legs can be a real salvation, because effective means help stimulate, restore, nourish and regenerate tissues, and stop the inflammatory process.

Affect certain areas of the skin. The focus is most often provoked by an infectious pathology. The types of ulcers are:

Preceding the appearance of ulcers on the feet, heels, phalanx of the big toe can systemic infectious diseases when non-healing wounds with uneven edges appear and the reasons for this are the constant wearing of cramped shoes, a long stay on your feet. Can cause ulcers radiation or chemical exposure, cold or freezing feet when exposed to low temperatures.

Treatment with ointments is included in the complex of methods to suppress the inflammatory process, cleanse necrotic areas from purulent accumulations, improve tissue trophism, accelerate wound healing.

Today, pharmacies sell ointments with a wide spectrum of action. The main thing is to choose a good ointment for trophic ulcers on the legs, thereby speeding up the healing process.

When to apply

Treatment with ointments is applicable at any stage of the course of the disease. When choosing drugs and prescribing a treatment course doctors take root causes into account development of the disease, possible provoking factors.

Ointments (course application):

• sometimes allow to avoid surgical intervention;
• nourish the tissues and integuments of the skin;
• improve trophism;
• normalize metabolism, venous outflow and blood circulation;
• stimulate the growth of new healthy cells;
• saturate cells with collagen and nutrients;
• clean wounds from necrosis, promote healing.

Reference! The greatest effect is observed at the initial stage. In advanced cases, of course, treatment with ointments alone becomes insufficient.

Stages of ulcers

Trophic ulcers on the legs have 4 stages:

Even if it is possible to heal wounds, unsightly scars remain on the affected areas.

Ointments for the treatment of trophic ulcers of the lower extremities are prescribed taking into account the stage of atrophy lower limbs.

All drugs are different in composition and action, therefore don't self-medicate, neglect the advice and advice of the attending physician. Local preparations should be directed to:

• elimination of pain syndrome;
• activation of healing processes;
• trophic improvement;
• tissue microcirculation;
• cleansing the infection from purulent, serous contents.

1. Ichthyol ointment to relieve inflammation, soreness, activate blood circulation in the affected areas. It can be used at the 1st stage of the disease.
2. Vishnevsky ointment for the regeneration of damaged areas, cleansing of purulent accumulations.
3. Solcoseryl as an effective ointment for trophic ulcers on the legs at the 2nd stage of the disease to improve trophism and the condition of blood vessels in the legs, saturate and replenish oxygen, restore tissues, heal wounds and relieve swelling, as well as to stimulate metabolic processes, accelerate tissue regeneration with an effect on 1 -th stage.
4. Actovegin with the use of trophic ulcers at stages 1-2 even before the appearance of granulations to cleanse wounds, eliminate the spread of infection, nourish tissues, improve trophism and blood supply, restore affected areas, as well as increase cellular and energy metabolism.
5. Algofin in the composition with antimicrobial components, it helps at the 1st and 2nd stages of the disease, leading to the launch of regenerative processes in tissues, the removal of inflammation, and the suppression of microbial flora.
6. Argosulfan in the composition with silver extract, effective at 1-2 stages to suppress microorganisms, accelerate the healing process of wounds.
7. Levomekol with trophic ulcers with the use at the initial stage of the disease to provide wound healing, analgesic, antimicrobial effects.
8. Betadine with the use of the 2nd stage of the disease when granulations appear in the wounds, suppression of viral and fungal infections.
9. Wundehill as an excellent immunostimulant with use at the 3rd stage of the disease to remove necrotic and purulent formations, relieve inflammation, heal wounds.
10. Bepanthen in the composition with active panthenol and efficiency at 1-2 stages.
11. Comfrey ointment with bruises and trophic ulcers on the legs for healing, restoring the skin, relieving inflammation.
12. Sea buckthorn oil and with the impact at the initial stage of ulcer development to accelerate the healing of damaged tissues, reduce inflammation.
13. Stellanin ointment for restoring blood flow in the capillaries, activating the growth of blood vessels, stimulating and regenerating the skin, cleansing wounds from purulent accumulations.
14. Liniment aloe as a biological product for stimulating metabolism, normalizing trophism. Let's apply in a complex with other medicines at an initial stage of an illness.
15. Diclofenac from the group of NSAIDs to relieve pain, eliminate convulsions in severe manifestations of venous insufficiency. Effective at any stage of the disease.
16. Fluorocort with the appointment of complications of venous eczema, trophic ulcers.
17. Dermazin in the composition with ionized silver to relieve inflammation, stimulate and cleanse wounds on the legs.
18. Iruxol with the appointment at any stage of the development of diabetes for wound healing, suppression of harmful purulent microflora.

Which ointment for which stage

Ointments are designed to eliminate infection of wounds, heal defects on the feet. The most effective, taking into account the stage of development, are:

• antifungal, non-steroidal, antihistamines at the stage of exudation with a pronounced release of purulent exudate against the background of the inflammatory process;
• antibiotics when a bacterial infection is attached, to suppress inflammation and infectious agents, to cleanse wounds from exudate;
• antioxidants, as wound healing ointments for trophic ulcers in the composition with hyaluronic acid at the stage of repair or scarring of the affected areas, when the inflammatory process is already on the decline and the formation of granulation in the wounds is noticeable.

Attention! It is important to understand that trophic leg ulcers will not begin to heal on their own, they can only provoke complications and lead to the development of gangrene, a malignant neoplasm.

When choosing drugs, it is necessary to adequately assess the condition of the ulcers, the stage and degree of development of the disease, the existing symptoms to achieve the best effect.

In no case you can not try to be treated on your own and resort to dubious folk methods. The appointment of treatment should be dealt with exclusively by the attending physician in order to avoid aggravating the situation, increasing the development of the inflammatory course.

Contraindications

Almost any ointment for healing trophic ulcers can cause harm instead of good, because. has its contraindications. When choosing, be sure to read the instructions, but it is best to first consult with your doctor.

Drugs such as:

• Levosin, Levomekol have hypersensitivity;
• Chloramphenicol, Solcoseryl are not applicable for excessive granulation in wounds and hypersensitivity to the components;
  Ofloxacin is contraindicated in women during pregnancy, since there is no evidence of the safe use of the drug and the effect on the fetus;
• Mefenat is not recommended for use by women while breastfeeding, it is prescribed only for medical reasons. As side effects, it can cause allergies;
• Streptotinol is not prescribed for strong discharge of purulent contents from wounds, excessive sensitivity to active substances.

Side effects

Ointments for trophic ulcers often cause side effects such as allergies at the sites of application, for example:

• Solcoseryl, Streptonitol, Levomekol can lead to redness, burning, itching;
• Methyluracil, erythromycin ointment - to soreness at the site of application.

If side unpleasant symptoms appear, the use of ointments should be stopped and the selection of other analogues should be discussed together with the attending physician.

It is difficult to imagine what kind of disease can cause trophic ulcers on the legs. Often the cause is in the usual infection with microbes and bacteria., entry of pathogenic microflora under the skin capable of inducing an inflammatory process.

But it happens that trophic ulcers are a complication of serious diseases: varicose veins, hypertension, diabetes mellitus when degenerative processes begin to occur in the hematopoietic system.

Trophic ulcers are treated quite difficult and long. Wounds become wet, heal poorly, and may remain necrotic for several years. Also affected by age, the degree of neglect of the underlying disease.

For prevention

Ointments should contribute to the activation of blood circulation processes and the suppression of inflammatory processes. Otherwise, gangrene, osteomyelitis may begin.

As a preventive measure, it is worth advising:

• prevent the appearance of purulent manifestations from wounds;
• timely treat the affected areas and cracks in the skin with antiseptics;
• wear comfortable and sized shoes;
• prevent hypothermia of the lower extremities;
• protect the skin from injuries and cuts, infection, exposure to ultraviolet radiation.

Conclusion

When non-healing weeping wounds appear, it is better not to delay contacting specialists, undergoing a full examination. Degenerative processes in tissues and cells will become simply irreversible, which means they will lead to disability.

The lower extremities require long-term complex treatment in combination with the therapy of the underlying disease.

Treatment of trophic ulcers is a long and difficult process that requires a balanced and detailed analysis of the cause of the disease. The art of the doctor consists in the correct combination of therapy for the underlying disease that caused the weakening of the body with the treatment of a skin defect.

A single cure for trophic ulcers (such a miracle pill or super ointment) does not exist, and it is unlikely that it will appear in the foreseeable future, so the skill of a doctor is to correctly combine the already available powerful medicines.

Trophic ulcers and principles of their treatment

A skin lesion that does not heal for six weeks, or tends to recur, is diagnosed as a trophic ulcer. It is not an independent disease, but occurs as a consequence of the underlying pathology of the body.

Skin lesions are localized mainly on the legs, rarely occurring on the arms, trunk and head. The main cause of an ulcer is a failure in tissue nutrition and their subsequent necrosis due to impaired blood flow and oxygen starvation. Pathology of the blood supply occurs due to:

• vascular disorders;
• pathologies of lymph outflow;
• accession of infections;
• metabolic disorders;
• development of autoimmune processes.

When planning the treatment of an ulcer, the doctor proceeds from the fact that the underlying disease requires treatment in the first place, the very appearance of a long-term non-healing skin lesion indicates the severity of the course. The combination of the depth of the underlying disease, secondary pathologies and the ulcer itself poses different tasks for the doctor, the main goal of which is to achieve a tendency to wound healing, reduce its size, stop the possibility of opening new ulcers and alleviate the course of the underlying disease.

There are trophic ulcers:

• venous or varicose, arising against the background of varicose veins and thrombophlebitis;
• arterial and ischemic, arising against the background of lesions of the vessels of the lower extremities - obliterating atherosclerosis, obstruction of the arteries of the extremities, diabetes mellitus;
• hypertensive (Martorell's ulcer), the causes of which are hypertension and vascular disorders;
• neurotrophic - ulcers of the legs and feet due to diseases and injuries of the brain and spinal cord, peripheral nerves against the background of diabetes mellitus, infectious, toxic or congenital disorders of nervous sensitivity;
• infectious or pyogenic - caused by the addition of an infectious agent;
• caused by skin diseases - eczema, dermatitis and psoriasis;
• post-traumatic, caused by fire, chemical and mechanical injuries, gunshot wounds, bites, disorders in the healing of postoperative sutures of the hands, arms, legs, shins, scars after operations, at the injection site of drug addicts;
• caused by systemic diseases of the connective tissue, rheumatic lesions of the joints, lupus erythematosus;
• caused by common diseases - severe pathologies of the heart (ischemia, malformations, heart failure), renal and hepatic insufficiency; anemia and blood diseases, metabolic disease, beriberi and prolonged starvation.

In some cases, treatment can only restrain the development of an ulcer and has no prospect of healing a defect - such lesions include wounds caused by connective tissue diseases, malignant tumors, severe and extensive ulcers caused by age. The direction of treatment and the types of medications used by the doctor depends on the type of ulcer.

Treatment of trophic ulcers is complicated by the fact that all of them are infected.

Pathogenic flora supports the inflammatory process and necrosis in tissues, provoking complications. The most common wounds become infected:

• staphylococci;
• enterobacteria;
• anaerobes;
• Pseudomonas aeruginosa;
• pseudomonads;
• Klebsiella.

Attachment of infection to wound processes is manifested by the release of pus and serous compartments, the development of additional inflammatory processes.

Complications of trophic ulcers are:

• erysipelas;
• phlegmon;
• eczema;
• osteomyelitis;
• lymphadenitis;
• inflammation of the joints;
• malignant transformations;
• bleeding;
• tetanus.

The use of antibiotics for the treatment of trophic ulcers on the legs should be balanced and justified, their use in uncomplicated forms leads to bacteria mutations into new, especially resistant strains.

In practical treatment, physicians mainly encounter mainly venous (80%), ischemic and neuropathic (diabetic) ulcers or mixed ulcers.

For treatment apply:

• conservative medical treatment;
• local effect on trophic ulcers;
• methods of surgical correction;
• physiotherapy methods.

The goal of conservative treatment is to reduce the area of ​​wound lesions, relieve inflammation and heal the ulcer. The most effective is the use of drug treatment for wounds that have not yet penetrated to the tendons and joints.

How to cure trophic ulcers? Russian doctors are more inclined to surgical treatment of trophic ulcers, while noting a faster rehabilitation of the patient, while doctors in Europe and the USA mostly use conservative treatment at home.

Preparations for conservative treatment

In the conservative treatment of a patient with a trophic ulcer, the doctor starts from the main lesion that caused it.

Varicose ulcers occur against the background of thrombophlebitis or varicose veins, which is caused by stagnation and reverse flow of blood in large and small veins. Blood flow disorders depend on the weakness of the venous valves, which is caused by a number of different causes - from trauma to heredity. Ulcers of this type arise and develop quickly.

Martorell's ulcers and arterial ulcers are provoked primarily by hypertension, which is caused by a violation of blood flow through deformed arteries. As a result of a decrease in blood flow through small vessels, tissue trophism, cell death and ulceration are disrupted.

With diabetes, there are multiple disorders in the body - nervous and vascular, metabolic and hormonal, which result in insensitivity to injuries, inflammation and death of small vessels, a tendency to poor healing of all types of wounds.

The development of ulcers can take place against the background of traumatic injuries of various types.

Since 90% of trophic lesions of the skin are caused by vascular pathologies, the following groups of drugs are used in their treatment:

antibiotics to destroy pathogenic flora;
phlebotonics, which are used to strengthen the walls of blood vessels, improve blood supply and oxygen supply to tissues;
antithrombotic drugs for the treatment of trophic ulcers, making the blood less capable of clotting;
anticoagulants that thin the blood;
antispasmodics, anesthetize by relieving vasospasm and improving blood flow, analgesics;
anti-inflammatory drugs from the group of non-steroidal;
means to improve metabolism;
systemic enzymes;
drugs that remove cholesterol and pancreatic enzymes from the blood.

Drugs that strengthen blood vessels

Troxevasin

The agent reduces swelling and tones the walls of blood vessels by reducing permeability, improves capillary blood flow. The use is intended to relieve convulsions, heaviness and pain in the legs when diagnosing trophic disorders and ulcers. Available in the form of a gel or tablets.

Venorutin

A drug similar in action to Troxevasin, the active substance is hydroxyethyl rutoside, the release form is a yellow odorless gel.

Venarus

The active substance - Diosmin and Hesperidin, is prescribed to strengthen the walls of blood vessels and regulate blood flow, reduce vascular permeability, and eliminate blue vascular marks on the skin. Detralex has the properties to tone up blood vessels and influence the functioning of venous valves and regulate blood flow, preventing backflow of blood or its stagnation. It has properties to eliminate the permeability of small capillaries and stop inflammation. Eliminates pain and swelling in the legs, relieves the feeling of heaviness, returns the sensitivity of the limbs. Produced in the form of tablets.

Phlebodia

The active substance is Diosmin. Produced in the form of tablets, it strengthens the walls of blood vessels and reduces the permeability of capillaries, keeping them within normal limits, without expanding. It has the ability to relieve inflammation and normalize blood flow, improving tissue trophism.

Drugs that affect blood viscosity

Heparin

It has the ability to reduce swelling, have an anti-inflammatory effect, promotes the resorption of blood clots. Used as an injection. During treatment, the use of non-steroidal anti-inflammatory drugs is prohibited.

Dicoumarin

An agent that helps reduce blood viscosity. It is used to prevent the occurrence of blood clots after operations and prolonged forced lying down, in the postpartum period, prevents blockage of peripheral vessels.

Urokinase

It is used to reduce blood viscosity and reduce the risk of blood clots, as a means of improving blood flow in obliterating atherosclerosis of the vessels of the legs. When combined with heparin, caution is required.

Streptokinase

It acts as an agent that affects blood clots, and improves blood flow in all types of vessels, tissue trophism, and can restore the patency of small vessels.

Aspirin

It is used exclusively on prescription as a means of reducing blood viscosity. The daily dose should not exceed 0.3 g per day, the analogue is Cardiomagnyl.

Xarelto

The drug for thinning the blood of a new generation. Daily dose 0.1 g.

Antispasmodics

No-Shpa, Drotaverine

The active substance - Drotaverine, dilates blood vessels and relieves spasm, eliminates pain, helps to lower blood pressure. It does not affect blood pressure and the central nervous system.

Papaverine

It lowers the tension of blood vessels and relaxes their walls, relaxes the fibers of the smooth muscles of the internal organs of a person, helps to reduce blood pressure.

Spazmalgon

The agent of the combined composition, has a strongly pronounced effect due to the targeted action of metamizole sodium (NSAIDs), pitofenone hydrochloride (relaxing effect on the walls of blood vessels) and fenpiverinium bromide, which relieves spasm of the smooth muscles of internal organs, allows you to temporarily anesthetize a trophic ulcer.

Ibuprofen

It has a combined analgesic, anti-inflammatory, lowering body temperature effect. The mechanism of action is the suppression of the production of the hormone prostaglandin in the body and inflammation, due to which pain, swelling and high temperature will be relieved.

Antihistamines

To suppress possible allergic reactions, the doctor prescribes Tavegil and Suprastin, the funds are used for concomitant skin lesions.

Antibiotics

Treatment of trophic ulcers of the lower extremities involves broad-spectrum antibacterial drugs.

The main motives for prescribing antimicrobials and antibiotics is the presence of a profuse festering wound, flowing from the affected area of ​​serous contents, a bright border of inflammation around the wound. The basis for prescribing antibiotic treatment is purulent complications (cellulitis) and erysipelas. Treatment of such complications with antibiotics has a good clinical prognosis.

For therapy, the doctor chooses antibiotics of 3-5 generations:

• cephalosporins (Ceftazidime, Sulperazon);
• fluoroquinolones (Ciprofloxacin, Ofloxacin);
• carbapenems (Meropenem, Tienam);
• protected group penicillins.
• Lincosamides (Lincomycin, Clindamycin).

Metronidazole, which acts on anaerobic infection, is used in the treatment. After obtaining data from bacteriological culture and a test for the sensitivity of the microflora and the body, the correction of the drug used can be carried out for a more effective effect.

The rule of thumb is that once there is a reduction in signs of inflammation and the ulcer is in a healing state, antibiotic therapy is discontinued.

The limited use of antibiotics is important - otherwise the microbial flora may change and antibiotic-resistant strains may appear.

A common mistake in the treatment of patients with diabetic foot is ignoring the degree of damage to the body by the disease, as a result of which there is an increase in renal failure. The appointment of the usual average doses greatly weakens the body, worsens the patient's condition and the effectiveness of ulcer healing. This is due to:

• enhancing the toxic effects of drugs due to poor excretion of decay products;
• that some drugs may not fully manifest if kidney failure is diagnosed.

The use of antibiotics in the treatment of patients with should be very careful.

Means that improve metabolism

The preparations of this group include FIShant-S, which is based on natural ingredients. The drug has the ability to remove bile preparations and toxins from the body, cleansing the body without injuring the liver. The manufacturer claims that the drug is capable of:

• normalize metabolism;
• reduce the level of cholesterol in the blood and organs;
• restore liver function;
• regulate digestion after removal of the gallbladder;
• normalize the work of the pancreas;
• eliminate toxins after poisoning and the use of drugs;
• act as a means of preventing atherosclerosis.

The drug is prescribed by a doctor, the course of treatment is up to 12 months.

Normalization of metabolism with systemic enzymes (Wobenzym, Phlogenzym) allows you to restore blood flow, relieve inflammation in the ulcer area and mobilize the body's forces for wound healing.

It is necessary to be treated at home with medications as directed by a doctor; the process must be under his control due to the duration.

Some application patterns:

• Askorutin - take two capsules three times a day, after meals for at least 14 days, unless otherwise prescribed by a doctor.
• Detralex - 1 tablet in the morning and evening with meals during the first week, then 2 tablets for 1 dose per day.
• Phlebodia take 1 pc. 60 consecutive days, with multiple trophic ulcers - 6 months.
• Actovegin - a daily dose of 6 tablets, taken before meals, 30 minutes before. drinking clean water.
• Troxevasin no more than 2 tablets during a meal, the daily dose can only be increased by the attending physician for a month.

To improve blood microcirculation and better healing of trophic ulcers, agents that affect the function of blood clotting are used. Effective treatment with Pentoxifylline (at least 1200 mg per day) and a synthetic analogue of the hormone prostaglandin E2 Alprostadil. This effect is commonly used for arterial, venous and mixed trophic ulcers.

Local treatment of ulcers

Complex treatment of trophic ulcers is impossible without local therapy of the lesion. To treat them, the doctor uses general surgical practices used for all types of wounds, taking into account the peculiarities of their course in a particular patient. Only the combined effect of conservative treatment and medical treatment of the wound can heal the patient from a wound that has been tormenting him for more than one month, and sometimes even a year.

A doctor treating a trophic ulcer must not only understand the processes that occur in the patient's body and in the wound, but also adequately respond to changes.

It is important to choose the right drug for the treatment of trophic ulcers on the leg and dressing material to influence the wound.

To monitor the condition of the wound, a "color" scale is used, which corresponds to the cycles of development or healing of a skin lesion:

• black and yellow (if there is a Pseudomonas aeruginosa infection - gray or green) wounds are the first phase of ulcer development;
• red wound - the process moved to the second stage, dead masses began to be removed from the wound;
• the wound becomes white in the process of healing and restoration of the skin.

Topical preparations for trophic ulcers help remove dead tissue from the wound, stop the infection and stop inflammation, and improve the nutrition of living tissue and their growth.

They are used for purulent varicose and venous ulcers, neurotrophic and ischemic skin lesions, post-traumatic and mixed ulcerative defects.

To care for the wound surface use:

• drugs based on antibiotics and biological substances - Levomekol, Actovegin, Solcoseryl;
• disinfect the wound and, in combination with oral antibiotics, prevent re-inflammation;
• ointments based on herbal remedies - Vulstimulin, used for current ulcers, relieves inflammation and reduces pain;
• preparations for the rapid restoration of wound coverage and improvement of cell growth - Bepanten, Curiosin;
• ointments for the fastest restoration of the skin, healing and pain relief - Solcoseryl.

Vulstimulin

Ointment for weeping and infected trophic ulcers, contains wheat germ extract, essential oils, phenoxyethanone, sorbitol. It has a wound-healing and anti-inflammatory property, applied around the wound no more than 2 times a day. The doctor prescribes.

Iruxol

Contains collagenase, not subject to long-term use. Clears the wound of dirt and infection.

Solcoseryl

It has an antibacterial effect, helps to regenerate areas of destroyed tissues. There is no information on negative side effects. Discomfort, tingling and burning in the wound is a consequence of the effective effect of the drug.

The composition of the ointment includes a processed calf blood extract, which accelerates tissue metabolism, nourishes and promotes healing.

Delaxin

The ointment is interesting by the effect of artificially recreated tannin, which can form a molecular film on the surface of the wound that protects the wound from infection and suppuration. It has the ability to accelerate tissue regeneration, relieve pain, itching, swelling. Has an antibacterial effect. Release form - powder or cream.

Levomekol

The main active ingredient is the antibiotic chloramphenicol (Levomycetin), the auxiliary is methyluracil. The agent disrupts the reproduction of bacteria in the wound (levomycetin) and stimulates tissue repair (methyluracil).

Levosin

The constituent substances are chloramphenicol, methyluracil, sulfadimethoxine and trimecaine hydrochloride, which helps to anesthetize a trophic ulcer. It has an anti-inflammatory effect, is considered one of the most effective drugs.

Sulfargin

Contains silver sulfathiazole, has the ability to block the reproduction of pathogenic microorganisms in the wound, promotes rapid healing due to silver ions.

For the treatment of trophic ulcers, ointments containing antibiotics Erythromycin, Streptonitol, Oflokain, Mafenide and Methyluracil, which stimulate the activity of leukocytes in the ulcer zone and promote regeneration of the affected tissue, are actively used.

Some contraindications for topical preparations:

• Levomekol and Levosin - a reaction to levomycetin.
• Streptonil - intolerance to streptocide, forms an excessively weeping wound.
• Solcoseryl - a reaction to the components of the drug, excessive tissue growth in the wound.
• Dioxicol - excessive sensitivity to the drug.

The reaction to the drug is manifested by itching, swelling and redness of the tissue around the ulcer and at the site of application to the wound. It is possible to damage the skin with dermatitis after the use of Dioxicol and Oflokain.

Ointments for the treatment of trophic ulcers should be stored at room temperature, ointments with silver - at +10 degrees Celsius.

ASD, fractions 2 and 3

Treatment of trophic ulcers of the lower extremities with folk remedies includes the use of herbs for washing wounds, various home-made ointments. In some cases, folk remedies show better results than medications.

A drug that causes a lot of controversy, and has both opponents and fans, is the ASD remedy (Dorogov's antiseptic stimulator).

The history of the development and use of this domestic drug is quite interesting and dates back to 1943. Officially, ASD is a drug used in veterinary medicine, the production technology is the processes of heating and sublimation of meat and bone raw materials. Represents liquid of yellow color with a shade in red with release of a sharp specific smell.

The drug acts on the body at the cell level as a stimulant that restores hormonal balance, normalizes the functioning of the nervous system, the body's immune defenses.

ASD fraction 2 acts on the body not as a killer of pathogenic flora, but as a tissue preparation involved in the processes of the human body. It is taken orally, activates the central nervous system and the autonomic nervous system, increases enzymatic activity. It can be used externally as an antiseptic.

ASD of the third fraction is a thick coffee-colored liquid, intended for external use, including for skin diseases and trophic ulcers. For treatment, trophic ulcers are washed 2 times a day (a sponge and laundry soap are used), dried with a sterile cloth and lubricated with ASD (third fraction), previously diluted with vegetable oil at a ratio of 20:1. According to the same recipe, bedsores can be treated, after removing all the folds from the patient's bed. Skin lesions (pressure sores) in places of greatest pressure on the bed are formed in bedridden patients due to loss of skin sensitivity. To treat ASD, bedsores are gently washed with a sponge infusion of medicinal herbs, dried and lubricated with the drug.

Modern medicine does not stand still - more and more modern effective means are being developed for the treatment of trophic ulcers, the effectiveness of which depends on the characteristics of the patient's body.

With a trophic ulcer, the skin and soft tissues are damaged. Wounds do not heal for a long time. Provoking factors are various diseases, most often varicose veins or diabetes mellitus. Mostly develop trophic ulcers on the legs. Treatment takes a long time.

Successful treatment of trophic ulcers of the lower extremities lies in an integrated approach. All doctor's recommendations must be followed. The treatment regimen is developed individually, taking into account the symptoms and stage of the disease.

An effective remedy should not only eliminate the symptoms, but also deal with the main provoking factors. In advanced stages, to reduce pain, the doctor may prescribe painkillers. You cannot stop treatment on your own.

Trophic ulcer is not an independent disease

Preparations for the treatment of trophic ulcers:

1. Phlebotonics - strengthen the venous walls, restore their elasticity, normalize blood flow. These include "", "Venoruton", "", "".
2. Fibrinolytics - can provoke bleeding, therefore, they are prescribed only under the supervision of a doctor in a hospital. These include "Streptokinase", "Urokinase".
3. Anticoagulants - help thin the blood, preventing blood clots. These include Dicoumarin, Heparin.
4. Anti-inflammatory drugs that do not contain steroids reduce the severity of pain syndromes, stop inflammation. They are characterized by a slight anesthesia with lesions of the skin. The most common drug in this group is Ibuprofen.
5. Antispasmodics. These include Papaverine and No-shpa.
6. Preparations for accelerating the metabolism of fats.
7. Antibiotics - in the acute process of inflammation.

Medical treatment is supplemented with solutions and ointments against infection. They speed up wound healing. Depending on the degree of trophic ulcers on the legs, choose different ointments:

Antibacterial drugs - used in the early stages, when the defect is small

1. With small sizes at the initial stage of the disease, an antibacterial agent for trophic ulcers in the form of an ointment is used. These are Actovegin, Levomekol. They effectively disinfect the wound, do not allow the attachment of a secondary infection.
2. Then the therapy of trophic ulcers on the legs involves the use of ointments with components of plant origin. It is important to completely eradicate the infection.
3. A small layer of epithelium appears on the surface of the ulcer. To accelerate the regenerative processes and wound healing in the leg area, Mefanat, Bepanten are used.

These drugs for the treatment of trophic ulcers are the most effective and popular.

Venotonics

With a trophic ulcer, they are often used, as they have a therapeutic effect on the venous walls. Venotonics include:

The choice of a specific remedy by a doctor depends on the stage and signs of the disease.

Means for improving fat metabolism

The most common tablets in this group for trophic ulcers are Fishant-S. It contains components of natural origin. It is effective for varicose veins and ulcers:

• cleanses the body of toxins, neutralizes their effects;
• normalizes the content of cholesterol in the blood;
• protects against the appearance of cholesterol plaques.

Medical treatment takes from 2 to 12 months. The drug is not recommended for pregnant women, with individual intolerance to the components, as well as for children under 12 years of age.

Means that improve fat metabolism - remove toxins from the body, regulate the level of cholesterol and pancreatic enzymes

Anticoagulants

To make the blood thinner, drugs of this group are prescribed. They prevent thrombosis. Of the direct-acting anticoagulants, "Heparin" or medicines based on it are prescribed. Since the main component can provoke bleeding, you need to regularly monitor blood clotting.

Contraindications for use:

• ulcers;
• breast-feeding;
• intestinal inflammation;
• excessive permeability of the walls of blood vessels;
• cachexia.

A more detailed list of contraindications contains instructions for the medicine.

Antibiotics

Fight wound infections. Depending on the degree of the disease, the doctor prescribes different forms of drugs. Tablets from a trophic ulcer are appropriate for an acute inflammatory process. Only a doctor should prescribe funds for trophic lesions, since negative consequences are possible.

Topical preparations

If trophic ulcers appear on the legs, local therapy is used:

1. "Actovegin". Released in the form of a gel. It has healing properties. It is not forbidden to use for a long time. Negative consequences are practically not revealed.
2. Solcoseryl. Accelerates regenerative processes. When applied to the skin, a burning sensation may occur, but this is not a reason to refuse the drug.
3. Agrosulfan. It is used if there is a possibility of suppuration of the wound.
4. "Levomekol". The ointment has an antibacterial effect, accelerates regenerative processes.
5. Delaxin. The ointment forms a protective film on the wound. It prevents infection and suppuration of the ulcer. It has a drying effect, accelerates regenerative processes. Reduces itching, swelling, can be used as an anesthetic for trophic lesions.

Drug treatment is highly effective, but only a doctor should prescribe drugs. Self-medication can provoke negative consequences.

A trophic ulcer is a disease characterized by the formation of defects in the skin or mucous membrane, which occurs after the rejection of necrotic tissue and is characterized by a sluggish course, a low tendency to heal and a tendency to recur.

As a rule, they develop against the background of various diseases, are characterized by a persistent long course and are difficult to treat. Recovery directly depends on the course of the underlying disease and the possibility of compensating for the disorders that led to the onset of the pathology.

Such ulcers do not heal for a long time - more than 3 months. Most often, a trophic ulcer affects the lower extremities, so treatment should be started when the first signs are detected at the initial stage.

Causes

Violation of the blood supply to the skin area leads to the development of microcirculation disorders, lack of oxygen and nutrients, and gross metabolic disorders in the tissues. The affected area of ​​the skin becomes necrotic, becomes sensitive to any traumatic agents and infection.

provoke the occurrence trophic ulcers on the leg are capable of such risk factors:

1. Problems of venous circulation:, and so on (both diseases contribute to stagnation of blood in the veins, disrupting tissue nutrition and causing necrosis) - ulcers appear on the lower third of the lower leg;
2. Deterioration of arterial circulation (in particular, with,);
3. Some systemic diseases ();
4. Any kind of mechanical damage to the skin. It can be not only an ordinary, domestic injury, but also a burn, frostbite. The same area includes ulcers that form in drug addicts after injections, as well as the effects of radiation exposure;
5. Poisoning with toxic substances (chromium, arsenic);
6. Skin diseases, for example, chronic,;
7. Violation of local blood circulation with prolonged immobility due to injury or illness (bedsores are formed).

When making a diagnosis, the disease that caused the formation is very important, since the tactics of treating a trophic ulcer on the leg and the prognosis largely depend on the nature of the underlying venous pathology.

Symptoms of a trophic ulcer

The formation of an ulcer on the leg, as a rule, is preceded by a whole complex of objective and subjective symptoms, indicating a progressive impairment of venous circulation in the extremities.

Patients note increased swelling and heaviness in the calves, increased frequency, especially at night, the appearance of a burning sensation, "heat", and sometimes itching of the skin of the lower leg. During this period, a network of soft cyanotic veins of small diameter increases in the lower third of the leg. Violet or purple pigment spots appear on the skin, which, merging, form an extensive area of ​​hyperpigmentation.

In the initial stage, the trophic ulcer is located superficially, has a moist dark red surface covered with a scab. In the future, the ulcer expands and deepens.

Individual ulcers can merge with each other, forming extensive defects. Multiple advanced trophic ulcers in some cases can form a single wound surface around the entire circumference of the lower leg. The process extends not only in breadth, but also in depth.

Complications

A trophic ulcer is very dangerous for its complications, which are very serious and have poor prospects. If you do not pay attention to trophic ulcers of the limbs in time and do not start the treatment process, the following unpleasant processes may subsequently develop:

• lymphadenitis, lymphangitis;
• gas gangrene;
• skin cancer.

Without fail, the treatment of trophic ulcers on the legs should be carried out under the supervision of the attending physician without any initiative, only in this case the consequences can be minimized.

Prevention

The main preventive measure to prevent the occurrence of a trophic ulcer is the immediate treatment of primary diseases (impaired blood circulation and lymph outflow).

It is necessary not only to apply medicines inside, but also to apply them externally. Local exposure will help stop pathological processes, treat an existing ulcer and prevent subsequent tissue destruction.

Why is the disease dangerous?

A progressive trophic ulcer can eventually occupy significant areas of the skin, increase the depth of the necrotic effect. A pyogenic infection that has got inside can provoke the appearance of erysipelas, lymphadenitis, lymphangitis, and septic complications.

In the future, advanced stages of trophic ulcers can develop into gas gangrene, and this becomes the reason for urgent surgical intervention. Long-term non-healing wounds exposed to aggressive substances - salicylic acid, tar, can develop into malignant transformations - skin cancer.

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Treatment of a trophic ulcer on the leg

In the presence of a trophic ulcer on the leg, 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 the daily care of the affected area.

How to treat a trophic ulcer of the lower extremities? Several options are used, depending on the neglect of the pathological process.

1. Conservative therapy when the patient is prescribed drugs such as phlebotonics, antibiotics, antiplatelet agents. They will help cure most of the symptoms of the disease. Patients are often prescribed the following medications:, Tocopherol,. Such medication can only be prescribed by a doctor.
2. Local therapy, with which tissue and skin damage can be cured. In diabetes, ointments containing antiseptics and enzymes are used. These agents heal wounds and provide local anesthesia. Ointments that enhance blood circulation are not allowed to be applied to the open surface of a trophic ulcer. Ointments such as have a wound healing effect. The ointment is applied to a compress and whether special dressings are made.
3. Surgical intervention, which is produced after the healing of ulcers. During it, the blood flow in the veins in the affected area is restored. This operation includes shunting and phlebectomy.

For the treatment of wounds, the following preparations are used:, Eplan. At home, you can use a solution of furacilin or potassium permanganate.

Surgery

Surgical treatment of trophic ulcers of the lower extremities is indicated for extensive and severe skin lesions. The operation consists in removing the ulcer with surrounding non-viable tissues, and further closing the ulcer; at the second stage, an operation is performed on the veins.

There are a few various surgical methods:

1. Vacuum therapy, which allows you to quickly remove pus and reduce swelling, as well as create a moist environment in the wound, which will greatly hinder the development of bacteria.
2. Catherization - suitable for ulcers that do not heal for a very long time.
3. Percutaneous stitching - suitable for the treatment of hypertensive ulcers. Its essence is the separation of venous-arterial fistulas.
4. virtual amputation. The metatarsal bone and the metatarsophalangeal joint are cut off, but the anatomical integrity of the foot is not violated - on the other hand, foci of bone infection are removed, which makes it possible to effectively deal with a neurotrophic ulcer.

With an ulcer size of less than 10 cm², the wound is closed with its own tissues, tightening the skin 2-3 mm per day, gradually bringing the edges closer and completely closing it in 35-40 days. A scar remains at the site of the wound, which must be protected from any possible injuries. If the lesion area is more than 10 cm², skin grafting is used using the patient's healthy skin.

Medical therapy

A course of drug treatment necessarily accompanies any operation. Treatment with medicines is divided into several stages, depending on the stage of the pathological process.

At the first stage (the stage of a weeping ulcer), the course of drug therapy includes the following drugs:

1. Broad spectrum antibiotics;
2. , which include , etc.;
3. Antiplatelet agents for intravenous injection: and;
4. : , etc.

Local treatment at this stage is aimed at cleansing the ulcer from dead epithelium and pathogens. It includes the following procedures:

1. Washing the wound with solutions of antiseptics: potassium permanganate, furacilin, chlorhexidine, decoctions of celandine, string or chamomile;
2. The use of bandages with therapeutic ointments (dioksikol, levomikol, streptolaven, etc.) and carbonet (a special bandage for sorption).

At the next stage, which is characterized by the initial phase of healing and the formation of scars, healing ointments for trophic ulcers are used in the treatment - Solcoseryl, Actevigin, Ebermin, etc., as well as antioxidant drugs, for example, tolkoferon.

Also at this stage, wound dressings specially designed for this are used: sviderm, geshispon, algimaf, algipore, allevin, etc. Treatment of the ulcerated surface is carried out with curiosin. At the final stages, drug treatment is aimed at eliminating the underlying disease, which provoked the appearance of a trophic ulcer.

How to treat a trophic ulcer on the leg at home

When starting the treatment of trophic ulcers according to folk recipes, it is necessary to consult with your doctor.

At home, you can use:

1. Hydrogen peroxide. It is necessary to drop peroxide on the ulcer itself, then sprinkle streptocide on this place. On top you need to put a napkin, previously moistened with fifty milliliters of boiled water. Add two teaspoons of peroxide to this water. Then cover the compress with a bag and tie it with a scarf. Change the compress several times a day. And add streptocide when the wound becomes moist.
2. Healing balm in the treatment of trophic ulcers in diabetes mellitus. It consists of: 100 g of juniper tar, two egg yolks, 1 tablespoon of rose oil, 1 teaspoon of purified turpentine. All this needs to be mixed. Pour the turpentine slowly, otherwise the egg will curdle. This balm is applied to a trophic ulcer, then covered with a bandage. This folk remedy is a good antiseptic.
3. powder from dried tartar leaves. Rinse the wound with a solution of rivanol. Sprinkle with prepared powder. Put on a bandage. In the morning of the next day, again sprinkle with powder, but do not wash the wound before that. Soon the ulcer will begin to heal.
4. Trophic ulcers can be treated with antiseptics: wash the wounds with warm water and laundry soap, apply an antiseptic and bandage. These dressings are alternated with applications from a solution of sea or table salt (1 tablespoon per 1 liter of water). Fold gauze in 4 layers, moisten in saline solution, squeeze lightly and apply to the wound, compress paper on top, hold for 3 hours. Repeat the procedure twice a day. Between applications, a break of 3-4 hours, during which time the ulcers should be kept open. Soon they will begin to decrease in size, the edges will turn pink - which means that the healing process is underway.
5. Garlic poultices or compresses used for open ulcers. Take a multi-layered gauze or terry towel, soak in a hot decoction of garlic, squeeze out excess liquid and immediately apply to the sore spot. Place a dry flannel dressing and a heating pad or hot water bottle over the poultice or compress to keep warm longer.
6. Need mix egg white with honey so that these ingredients are in the same ratio. Whisk everything and apply on ulcers, including veins that hurt. Then cover with the reverse side of the burdock leaves. There should be three layers. Wrap with cellophane film and bandage with a linen cloth. Leave the compress overnight. You need to do this treatment five to eight times.

Remember that in the absence of timely and proper therapy, complications such as microbial eczema, erysipelas, periostitis, pyoderma, arthrosis of the ankle joint, etc. can develop. Therefore, you should not use only folk remedies, while neglecting traditional treatment.

Ointments for treatment

For the treatment of this disease, you can also use various ointments, both natural and purchased in a pharmacy. Effectively heal wounds and have an anti-inflammatory effect of the ointment of arnica, comfrey, as well as room geranium.

Often also apply Vishnevsky's ointment. Of the ointments that can be bought at the pharmacy, dioxycol, levomekol, as well as streptolaven and a number of analogues are especially distinguished.