Effective Treatment Approaches for Leg Ulcers: Strategies for Healing and Relief

Effective Treatment Approaches for Leg Ulcers: Strategies for Healing and Relief

General therapy principles

In some points, the therapeutic approaches differ depending on the cause.
In  the case of venous leg ulcers  , the focus is on compression treatment with firm bandages that are wrapped around the leg or compression stockings. Studies have shown that the healing rates of other therapies are also increased when compression therapy is used. It is supplemented by regular walking training. Varicose veins  or poorly functioning veins can be eliminated surgically.

Compression therapy – not always the right choice

As important as compression therapy is for venous disorders, it has the opposite effect on  arterial leg ulcers  , since they compress the vessels and thus possibly bring the remaining blood flow to a standstill. Therefore, depending on the extent of the circulatory disorder, surgical measures for vascular expansion or bridging with a vascular prosthesis are used.

wound treatment

In addition, the wound itself is treated – the ulcer is regularly cleaned (with drugs or mechanically by ablation) and covered with a special (“hydroactive”) wound dressing that keeps the wound moist without sticking to it.

Antiseptic substances that can be used to reduce or prevent germs are only used when necessary; if there is a pronounced infection,  antibiotics are  given. The wound can also be surgically removed and covered with a skin graft (shave therapy).

Sometimes  cortisone therapy is also  indicated. A therapy option that has been rediscovered in recent years (which takes some getting used to, but is very effective) is the application of fly maggots, which only feast on dead tissue and thus clean the wound.

Circulation and healing promotion

Circulation-enhancing drugs such as pentoxyfillin and  heparin  may improve the symptoms, while exercise therapy and  lymphatic drainage have a supporting effect . So-called growth factors that promote wound healing (e.g. a gel with PDGF-beta) can possibly be applied locally.

The application of gene therapy is in the experimental stage. With their help, attempts are being made to introduce growth factors directly into certain skin cells, to genetically “boost” a skin transplant so that it forms better vessels, or to introduce the gene for a growth factor into the wound with the help of a carrier virus.

 

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