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| Causes of leg ulcer Rx of varicose ulcer |
Causes of leg ulcer Rx of varicose ulcer
Rx of varicose ulcerA)Conservative Rx
1)elevation of affected limb.2)vertical leg drainage to reduce n eliminate leg edema
3)passive movements maintain mobility of ankle n foot
4)active movements of calf muscles
5)blue line bandage is applied spirally from toes to knee.
6)antibiotics n analgesics
7)ulcer with yellow base n poor granulation tissue recquire daily dressing.
8)absorbant adherent dressing with spirit application to promote drying n scaling
9)once ulcer is clean Orahesive powder may b applied on surface of ulcer.
B)Surgical Rx
1)incompetent perforators n varicose veins r treated by surgery or sclerotherapy.2)larger needs split skin graft
3)ascending phlebograph is done to detect incompetent calf perforating veins
4)subfascial ligation of Cocket n Dodd
*incision is made in lower half of leg 2.5 cm behind posterior border of tibia.
*incision deepened till deep fascia is reached n margins r undermined
*deep fascia is incised n lifted up.
*perforating veins r ligated n devided.
5)radical surgical approach
*superfascial varicosities r ligated n stripped with subfascial ligation of perforating veins.
6)by-pass operation
*for iliofemoral occlusion contralateral saphenous vein is passed suprapubically n anastomosed to affected side distal to occlusion
7)excision n skin grafting.
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