Leg ulcers of vascular origin and their therapy

Abstract

The ambulatory and hospital treatment of gravitational ulcers and the value of sulfonamides, antibiotics and sympathicolytic drugs are discussed. The following three types of bandages are described: the pressure, supportive and protective bandage. Their indications are enumerated. The results of a consequent carried out foam rubber compression therapy with the understanding cooperation of the patient are remarkable. Ligations of the saphenous and perforating veins and postoperative sclerotherapy have to be undertaken as causative approaches to the problem. The beneficial effect of ligation of the superficial femoral vein in postphlebitic states is not yet proven. The value of skin grafting and local surgery is appraised. In ulcers due to arterial disease elimination of vasospastic reflexes has to be achieved by interruption of sympathetic pathways either by injection or by operation. The value of etamon and priscoline® is discussed. The danger of sensitization by the topical use of drugs and antibiotics is also discussed. The usefulness of vitamins in the therapy of leg ulcers is not established. Prophylaxis is the most important factor in the therapy of peripheral vascular disease.