LOWER LIMB ULCERS

DEFINITION: For ulcers of the lower limbs is defined as a skin lesion / subcutaneous that does not tend to spontaneous recovery.

ETIOLOGY: They affect both sexes with a predilection for the female , with peak incidence over the 70 years. The main risk factors are : diabetes , arterial , venous insufficiency , hypertension and some drug therapies.

SYMPTOMS: The leg ulcers occur as an interruption of skin and subcutaneous tissue that does not tend to spontaneous recovery. They are often painful lesions that produce exudate.

DIAGNOSIS : The diagnosis is clinical (Visit Specialist). To define the best therapy are normally useful further investigations such as blood tests (diabetes) , measurement of blood pressure , Doppler ultrasound arterial venous leg ( superficial or deep venous insufficiency or chronic obstructive arterial disease) , evaluation of therapies in place (cortisone) , buffer of the bottom of the lesion (identification of the microorganism).

TREATMENT: For the treatment of ulcers of the lower limbs, there are no universal criteria of. Initially, the cause must be identified and subsequently established a suitable therapy. If we have a venous ulcer infected supported by a incontinent perforating, the therapeutic strategy will be the sterilization of the ulcer and subsequently an intervention under fascial ligation of perforating and last in a skin graft assisted by growth factors tissue PRP. If a wound has a genesis of arterial hypertensive subject pharmacological antihypertensive therapy will initially be , subsequently emoreologica and finally treated with growth factors tissue PRP.

COMPLICATIONS: Although the complications of ulcers of the lower limbs following the underlying disease. The main ones are edema , gangrene and infection.

TRAPIANTO DEMO epidermal SEC. OLLIER THIERSCH CON P.R.P.

In ulcers resistant to scarring even after appropriate dressings and medical therapies is indicated the treatment with growth factors tissue PRP completed or not by a transplant dermo epidermal.

Indications for surgery

The intervention is always indicated when there is an ulcer resistant to standard therapies.

Results

The results are very encouraging, although largely influenced by the underlying disease and the type of ulcer.

The intervention

It is performed under local anesthesia and can last depending on the extent ulcer 40 a 60 minutes. Initially, the patient picks up a small amount of blood which is then inserted in a centrifuge to select growth factors tissue. At the same time you run a local anesthesia in the donor area , normally the front face or back of the thigh. With a dermatome is removed a portion of the dermis and epidermis that is laid on a support soaked in antibiotic. It then carries out a section of the skin to fit perfectly to the size of the ulcer. At this point you aspire growth factors prepared in advance and create a preparation where immerse the skin donor. The ulcer properly prepared and sterilized is now ready to receive the skin donor after having infiltrated the base with growth factors. It then performs a dressing that will be maintained for 5/7 gg.

Conclusions relating to the intervention

• Duration intervention: 40-60 my
• Type of anesthesia: Local
• Dressings: 3
• Length of stay: 1 now
• Resumption of normal activities: In relation to the underlying disease