30 years old rotten legs went around seeking medical treatment, and finally cured here

Grandpa Zhang, 72, from Zhuzhou, Hunan Province, has not been very convenient to walk for more than 30 years, and his left ankle is always tied with gauze and bandages for a few times, and he can only walk slowly for a short distance. Recently, Grandpa Zhang's leg disease has become more serious, and it is almost impossible to walk.

Originally, when Grandpa Zhang was young, his left lower limb began to appear a lot of earthworm-like "green tendons", which did not care at the time, and then the left inner ankle appeared ulcerated, seepage, many times to seek medical treatment was not cured, the ulcerated surface was getting bigger and bigger, the exudate was more and more, and occasionally accompanied by a foul smell. In the past three months, the ulcer has expanded to half a calf, and Grandpa Zhang has originally given up until he was introduced to the Second People's Hospital of Hunan Province (Hunan Provincial Brain Hospital) for hand and foot surgery, and his condition finally improved.

Grandpa Zhang, who was received by Chief Physician Li Qiwei, Director of Hand and Foot Surgery, was diagnosed with chronic ulcers in his left calf and varicose veins in his left lower extremities after asking about his medical history and physical examination. After perfecting the relevant examinations and preoperative preparations, Professor Li Qiwei, Professor Chen Sihua and Dr. Zhou Xianpei performed two operations for the patients: the first time they performed varicose vein extraction in the left calf, debridement of the left calf, and negative pressure suction. The second debridement of the left calf is performed, and a skin graft is taken. The operation was very smooth, not only healed the wound, but also eliminated the causative factors of the ulcer, after more than a month of careful treatment and care, Grandpa Zhang has recovered and been discharged from the hospital.

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Director Li Qiwei introduced that among all the lower limb ulcers, ulcers caused by varicose veins account for more than 70%, 20% are other venous diseases, and the remaining less than 10% are caused by arterial diseases, lymphatic obstruction and neurological diseases, metabolic disorders, hematologic disorders and aliphaticitis.

Director Li pointed out that the lower extremity ulcer is mainly caused by peripheral vascular diseases, varicose vein ulcers, also known as congestive ulcers, old rotten legs, mainly caused by blood stasis of venous blood in the lower limbs. There are five main causes:

A. Weak venous wall and valve defects: the venous wall is relatively weak, which can be expanded under the action of venous pressure, and the expansion of the valve sinus causes the original venous valve to be unable to closely close, and the valve function is relatively incomplete and the blood flows backwards. Dysplasia or absence of valves, which can not play an effective role in preventing reflux, resulting in the onset of the disease;

B. Persistent increase in intravenous pressure: the venous blood itself produces a certain pressure on the valve due to gravity, which will not cause damage to it under normal circumstances, but when the intravenous pressure continues to rise, the valve will bear excessive pressure, gradually relaxing, prolapsing, and making it incomplete. This is more common in long-term standing work, heavy physical labor, pregnancy, chronic cough, long-term constipation, etc.;

C. Age factor: because the limb venous pressure only reaches the highest pressure when the height of the body is high, the body is not high before puberty, so the venous caliber is small, which can prevent venous dilation, so with the increase of age, the venous wall and valve gradually lose their tension, and the symptoms are aggravated;

D. Gender: female patients due to pregnancy, uterus compression of the veins of the lower extremities, venous return is blocked, resulting in an increase in the pressure of the veins of the lower extremities;

E. The anatomy of the blood vessels of both lower extremities is different: the left lower extremities are multiple.

Varicose vein ulcer is mainly a chronic skin ulcer that occurs in the lower and middle part of the lower leg, the initial inflammation is only exudative, and then the ulcer occurs, which does not heal for a long time, the deeper and deeper, the more rotten and larger, the skin around the ulcer is pigmented and blackened, hardened, eczema, desquamation, some have obvious itching, some patients do not heal for many years, and eventually a malignant change occurs.

The treatment of this disease should take a comprehensive treatment approach: first of all, the ulcer is debridement, the necrotic tissue is removed, the bottom of the ulcer is exposed, and then it is anti-inflammatory treatment, the inflammation around the ulcer is controlled, and local disinfection or systemic antibiotics can be applied. At the same time, stress therapy can be applied, which can tie elastic bandages, reduce intravenous blood stasis, and effectively promote ulcer healing. Finally, surgical treatment is performed to completely eradicate the varicose veins around the ulcer and promote better healing of the ulcer.

Finally, Director Li reminded that the postoperative rehabilitation exercise for ulcers caused by varicose veins in the lower extremities is also very important, and active and passive functional exercises are started after 2-3 weeks after surgery. Usually pay attention to daily care, do the following:

1. Avoid standing or sitting for a long time, and should always let the feet do lifting, put down the exercise, as far as possible to walk small.

2. You should develop the habit of wearing elastic socks for one hour every day, such as walking, brisk walking, cycling, running or treadmill.

3. You should develop a posture of lying down several times a day to raise your legs above your heart and maintain your knees bent, so as to promote venous circulation in your legs.

4. Maintain a normal weight, not overweight, overweight will increase the burden on the veins in the legs.

5. Avoid lifting weights over 10 kg.

6. Be sure to quit smoking.

7. Keep your legs and feet clean and avoid injuries.

8. If the skin on the legs is dry, please follow the doctor's instructions.

9. Check yourself every night for swelling in your calves.

10. Raise your legs about 6cm high when you sleep, and maintain the most comfortable posture, do not let your legs stiffen.

11. If the venous pressure is too high before treatment, elastic socks should be worn continuously during the day. Put on your elastic socks before you get up and do a few minutes of repeated leg lifting exercises. Because the swelling of the legs usually occurs after a few minutes of standing after getting out of bed.

12. Keep the elastic socks clean and pay attention to whether their elastic function changes. The elasticity of a pair of elastic socks can last about six months, so when the elastic socks lose their elasticity, they should be replaced immediately.

13. As long as you find lower extremity ulcers, pigmentation, lower extremity edema, etc., please go to a regular hospital in time.

Contributed by: Zhou Xianpei, Department of Hand and Foot Surgery, Second People's Hospital of Hunan Province (Hunan Brain Hospital).

Editor: Liu Yuchen

Image: Hand and Foot Surgery