Treatment
1. Treatment of the cause: For example, for allergic (drug eruption), the allergen should be cut off; for diabetic foot, attention should be paid to blood sugar control; for physical and chemical injuries, it should be treated Pay attention to staying away from the source of disease; occupational diseases, and try to eliminate disease-causing conditions as much as possible.
2. Supportive treatment: including good local immobilization, elevation of the affected area, good care, etc., pay attention to the balance of water and electrolytes, and provide a high-protein, high-energy and vitamin diet. Improve the patient's immunity.
3. Drug treatment: anti-allergic drugs, anti-parasitic drugs, antibiotics (anti-infection, wound protection), and drugs to promote ulcer healing, etc.
4. Surgical treatment: Malignant changes and cancerous changes caused by tumors or skin should be dealt with promptly.
Local treatment
① Ulcer debridement and dressing change; remove necrotic tissue, scars, old granulation tissue, foreign bodies, etc. until relatively healthy tissue with rich blood supply. For chronic ulcers with exposed bones, joints, etc. that require skin flap repair, the quality of wound treatment is one of the keys to the success of skin flap transplantation. Soak and rinse with hydrogen peroxide, chlorine, saline, and iodophor for 5 minutes respectively. Cover with iodine gauze. For severe local edema, use 3 hypertonic saline wet compresses, or add antibiotics and antifungals based on bacterial and fungal culture and examination results.
② Treatment of skin eczema: Fully follow the principles of use of external dermatology drugs: in the acute attack period, if there is a lot of exudation, apply 3 boric acid solution for wet compress, and after less exudation, use glucocorticoid cream ; Use halometasone cream or Baiduobang ointment in the chronic stage.
③Local physical therapy: Helium-neon laser, ultrashort wave, infrared and other local irradiation.
④ Surgical treatment: For patients with large ulcers that have not healed after long-term dressing changes or are accompanied by exposed bones, joints, tendons or steel plates, surgical treatment should be considered. In this group, 72 cases were treated with surgery (47 cases with simple skin grafting and 25 cases with skin flap repair), and 49 cases were treated with non-surgical treatment.
Systemic treatment
The purpose of systemic treatment is to fight inflammation, relieve itching, and improve the body's resistance.
①Application of antibacterial or antifungal drugs, intravenous application of antibiotics and antifungal drugs based on bacterial and fungal culture and examination results;
②Application of antihistamines and calcium , Vitamin C, etc.;
③ Drugs that improve the body's resistance: such as urticulin, etc.;
④ Correct anemia or hypoalbuminemia.
Treatment of other accompanying diseases: For patients with varicose veins of the lower limbs, diabetes, heart disease, hypertension, etc., please consult relevant specialists for formal and systematic treatment.
Four drug treatment methods
Lithospermum oil
Soak 100g of Lithospermum in sesame oil heated to 60℃~70℃ and leave it for 24 hours , filter out the oil and use it. When using, first use 75% alcohol to disinfect the affected surface (scrub any necrotic tissue with 30% hydrogen peroxide, then rinse and dry with salt water), then apply lithospermum oil twice a day until healing.
Ruyi Golden Powder
Make this medicinal vinegar into a thin paste and apply it to the affected area, twice a day. You can also make an ointment by mixing Ruyi Golden Powder and Vaseline in a ratio of 2:8 and apply it externally. If there are ulcers or excessive secretions, clean the wound first before using this medicine.
Mayinglong Musk Hemorrhoid Ointment
Although it is a hemorrhoid medicine, it is very effective for skin ulcers. Method: First use 75% alcohol to disinfect the local area, dry it with a dry cotton swab, apply an appropriate amount of this ointment, cover it with sterile gauze, and change the dressing once a day or every other day.
Compound calamine powder for external use
After local disinfection, sprinkle this medicine on the affected area, 1 to 2 times a day.
Honey treats skin ulcers
Honey has high nutritional value and can be taken internally to treat and alleviate various gastrointestinal diseases. Honey is also used in surgery and dermatology. Honey contains antibiotic substances, which have antibacterial and antiseptic effects, can inhibit the growth of suppurative bacteria and mold, and have astringent, anti-inflammatory, analgesic, myogenic, accelerated wound healing, and skin protection effects. Suitable for burns, scalds, frostbite, trauma, ulcers of lower limbs, thrush in children, etc.
The reason why honey can promote wound healing is that honey contains 40% glucose, 40% fructose and a variety of amino acids, vitamins and trace elements, which can nourish wounds. At the same time, honey has hygroscopic and astringent effects, can reduce granulation tissue edema and form a viscous protective barrier to prevent and treat wound infections, bedsores, lower limb ulcers, etc. It can scab the wound surface quickly and the epithelium heals well.
Clinical treatment methods
You can give mupirocin ointment for external use and apply it to the affected area twice a day. However, long-term use of antibiotics in Western medicine can make the human body dependent. , destroy the microbial balance of the human body, and also cause damage to liver and kidney functions. Therefore, traditional Chinese medicine is mostly used to treat skin ulcers. For example, first use 75% alcohol to disinfect the affected surface (scrub any necrotic tissue with 30% hydrogen peroxide, then rinse and dry with salt water), and then apply comfrey oil, twice a day; Or after disinfection, apply compound calamine externally and sprinkle it on the affected area 1 to 2 times a day. The healing will be slow.
It is recommended to use gauze soaked with rehabilitation fluid and apply it externally on the skin ulcer for 2 hours, twice a day. Mupirocin ointment should be applied externally in between wet compresses. The clinical effect is significant. Kangfuxin Liquid is a traditional Chinese medicine preparation. It has antibacterial and anti-inflammatory properties, improves immunity, accelerates wound healing, and shortens wound repair time. It can promote blood vessel proliferation, improve wound microcirculation, enhance granulation growth, strengthen wound repair, and has the properties of convergence, decomposition and muscle regeneration. It is an ideal drug for treating skin ulcers, especially chronic ulcers. Kangfuxin Liquid has no adverse reactions, is easily accepted by patients, convenient to use, and has satisfactory therapeutic effects.
Prevention
1. Actively control the primary disease, such as blood sugar control in diabetic patients.
2. For damaging environments, the skin should be protected or kept away from irritating environments. If it is cold, pay attention to keeping the skin warm to prevent the occurrence of chilblains.
3. Regular skin care: For patients who are bedridden for a long time, pay attention to turning over and patting on the back, and taking care of local skin to prevent the occurrence of bedsores.
4. Early detection and early treatment. Prevent skin cancer.
Reference for details
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