Therapy and treatment of a Leg Ulcer

Firstly a venous and arterial diagnosis is necessary (physical examination and duplex, eventually also other scanning procedures such as Angiography and phlebography). With arterial ulcers and ulcer mixtum (arterial and venous) the emergence of the ulcer leg that deteriorates the blood supply is of primary importance. Therefore the improvement of the blood flow is necessary – vascular surgery for the arterial operation.
With  ulcus cruris venosum the removal of the congestion in the leg is of primary importance. Therefore a vein operation is necessary – phlebology centre or vascular surgery.

Treatment methods for leg ulcers

  1. Conservative (compression bandages)
  2. Conventional operation
  3. Hybrid operation (endovascular + conventional + conservative)


Combination of operational procedures for patients with CVI and ulcers

The ulcer therapy is often is a combination of multiple treatment procedures.

  • Ulcer shaving
  • Stripping operation
  • Fasciotomy/Fascetomy
  • Hauer's endoscopic sub facial dissection (ESPD)
  • Dr. Karl May´s selective dissection
  • Endovascular treatment (radio waves and laser)

Treatment concepts in the Capio Clinic in the Park

  • Patients with Widmer´s CVI stage III  (C6 patients) with ulcus cruris venosum/leg ulcers
  • Exclusion Peripheral Arterial Occlusive Disease (PAOD)/blood circulation problem
  • Gradual treatment over several weeks
  • Crossectomy and/or RFITT (radio waves)
  • Dr. Karl May´s selective dissection
  • Periculosis local sclerotherapy with aethoxysclerol fluids  or foam
  • Local ulcus therapy (shaving et al.)
  • Skin grafts, when possible and necessary
  • Full compression therapy
  • Short NU intervals in close cooperation with experienced phlebologist with restrictive selection of useful wound dressings
  • Early and regular manual lymph drainage

Resumé
The treatment of ulcerated legs is a therapy that takes week to months; seldom does medical assistance come too late.

  • Early clarification of complaints (Ultrasound) and plan yearly check-ups
  • Don´t ignore small ulcers, have hope even with large ulcers
  • Do vein prophylaxis, early familial incidence and monitor occupational exposure analysis