Trophic Ulcer Treatment

Trophic Ulcer Treatment

Write short note on trophic ulcer.

Answer. It is also called as decubitus ulcer or pressure sore.

• Trophic ulcer is tissue necrosis and ulceration due to prolonged pressure.
• Blood flw to the skin stops once external pressure becomes more than 30 mm Hg and this causes tissue hypoxia, necrosis and ulceration.
• It is more prominent between bony prominence and an external surface.

“The Role Of Imaging Tests In Diagnosing Trophic Ulcers”

Trophic Ulcer Etiology

It is due to:

• Impaired nutrition.
• Defective blood supply.
• Neurological defiit: Due to the presence of neurological defiit, trophic ulcer is also called as neurogenic ulcer/neuropathic ulcer. Initially, it begins as callosity due to repeated trauma and pressure, under which suppuration occurs and gives way through a central hole that extends down into the deeper plane up to the underlying bone as perforating ulcer.

“Causes Of Trophic Ulcers”

Trophic Ulcer Sites

• Over ischial tuberosity
• Sacrum
• In the heel
• In relation to head of metatarsals
• Buttocks
• Over the shoulder
• Occiput

“Best Treatments For Trophic Ulcers”

Trophic Ulcer Clinical Features

• It occurs in 5% of hospitalized patients.
• Ulcer is painless and is punched out.
• Ulcer is non-mobile and base ofthe ulcer is formed by bone.

“Symptoms Of Trophic Ulcers”

Trophic Ulcer Management

• Cause should be treated.
• Nutritional supplementation is given.
• Rest, antibiotics, slough excision, regular dressings.
  • Vacuum-assisted closure: It is the creation of intermittnt negative pressure of minus l25 mm Hg to promote formation of healthy granulation tissue.
  • A perforated drain is kept over the foam dressing covered over the pressure sore. It is sealed with a transparent adhesive sheet.
  • Drain is connected to required vacuum apparatus.
    Once ulcer granulates well. Flap cover or skin grafting is done.
• Excision of the ulcer and skin grafting is done.
• Flaps: Local rotation or other flps (transposition flps).
• Proper care: Change in position once in 2 hours; lifting the limb upwards for l0 seconds once in l0 minutes; nutrition; use of water bed/air bed/air-flid floatation bed and pressure dispersion cushions to the affected area; urinary and fecal care; hygiene; psychological counseling.
  Regular skin observation; keeping skin clean and dry (using regular use of talcum powder); oil massaging of the skin and soft tissues using clean, absorbent porous clothing; control and prevention of sepsis helps in the management.