What is it?
Wound that appears in the legs or feet due to the difficulty of the blood returning to the heart. This difficulty arises from incompetence of the veins of the legs to push the blood upward. The disease is primarily related to a genetic tendency.
However, this difficulty would manifest earlier in sedentary and overweighted people or in those who stay long periods standing or sitting. It is also very common in aviation workers.
Characteristics and symptoms
Leg ulcers are open and deep wounds in the lower limbs, usually somewhat painful, which takes a long time to heal.
Located preferentially over the bones of the ankles, usually arise after mild trauma which forms a small wound that will not heal and gradually increases in size.
Ulcers are often accompanied by varicose veins, swollen legs and brown spots. There may be inflammation, with redness and presence of purulent secretion (pus).
It is also common the presence of allergy areas around the wounds. It is the stasis dermatitis, which forms reddish, scaly and itchy plaques.
The most important are the general measures. Moving the legs and feet as much as possible is crucial. The simple movement of contracting your toes repeatedly helps a lot to make the blood flow up the leg. Physical activities like walking, cycling and swimming are excellent. Bodybuilding is not indicated.
The use of elastic stockings is another measure of great importance. These should be dressed at waking time, preferably before getting out of bed and removed only at bedtime. There are several types of elastic stockings. The soft compression helps very little and is recommended only as an "adaptation" to the medium and heavy compression. Elastic stockings may not be used without medical advice. Some types of leg ulcers, like hypertension ulcers, may worsen with the use of them.
It is important to stay as long as possible with your legs elevated. It is recommended using a pillow under your heels when you go to bed, read or watch television. This elevation does not need to be exaggerated.
Most of the people will improve with these measures. Dressings are useful and should be guided by the physician. Today there are several choices of dressings that speed the healing of these ulcers, if the general measures are followed.
Despite antibiotic creams are still regularly prescribed by many doctors, they are increasingly falling into disuse due to causing bacterial resistance and to studies showing no benefits. Oral antibiotics should be prescribed only in cases of proven or strongly suspected infection.
Erysipela is common in these patients. It is a severe infection which should be treated with systemic antibiotics as soon as possible.
Peripheral vasodilator drugs may be used, but with variable results. Medications designed to thin blood may also be helpful.
In short, combating obesity and sedentary lifestyle, use of elastic stockings, when indicated, and the general measures are the main weapons to fight venous ulcers.
- Progressive pigmentary dermatosis, Schamberg's disease