الفهرس | Only 14 pages are availabe for public view |
Abstract Chronic leg ulcer is one of the most disabling problems that commonly presented to dermatologists. Recent studies showed that most common causes are vascular causes, neuropathic, traumatic, infection, connective tissue diseases and malignancy. Skin biopsies provide valuable information in diagnosis either for skin tumors presenting with ulcers or inflammatory ulcers with pathognomonic features, also ulcers with histologic features that support the diagnosis apart from helping to exclude certain diagnostic considerations. Different lines of management are postulated including the management of the underlying etiology if possible beside general supportive measures and systemic antibiotics. Local management includes skin cleansers, topical antiseptics and topical antimicrobials. Debridement has so many different techniques including surgical, mechanical, autolytic, enzymatic and biological. Wound dressings have classically been used to protect the surface of the wound and to prevent drying and contamination. Different types are used according to the nature of the wound (dry, wet or contaminated) in the form of hydrogels, alginates, hydrocolloides, foams and transparent films. Adjunctive management represents more recent lines for resistant cases. The role of growth factors was identified. Skin grafts for long standing ulcers, bioengineered skin or non bioengineered covers can be used for non healing ulcers. Compression techniques, hyperbaric oxygen and other investigational techniques are under trials. |