old rotten legs
Introduction
Introduction to old rotten legs "Old rotten legs" is also called "acne leg", a complication of varicose veins or superficial phlebitis, and can also occur in deep vein thrombosis syndrome. Most of the lesions are in the lower limbs. In the acute phase, the main symptoms are redness and heat pain in the lower limbs, and there are cord-like nodules or large-area agglomerations, all of which are pigmented. In the early stage of the lesion, the skin of the foot is pale when the lower limb is raised, the back of the foot is cold, the pulsation of the dorsal artery is weakened and disappeared, intermittent claudication, and then it is impossible to walk, the pain is unbearable when walking, and the pain is also felt after rest. In severe cases, the patient can sleep at night because of the pain. The general course of disease is longer. Due to the dryness and desquamation of the skin, it gradually develops to ulceration. The wound surface gradually expands and is not easy to heal. The traditional Chinese medicine belongs to the "dummy vein" because of the long-term work, the heat is damp and cool, and the blood stasis is complicated. The literature has the name of "pajama sore" and "skirt sore", which occurs in patients with long-term standing, weight-bearing walking, and varicose veins of the lower extremities. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: thromboangiitis obliterans
Cause
Old rotten leg cause
The disease that the folks call "old rotten legs" is mainly chronic skin ulcers in the lower middle and lower leg. At the beginning of the disease, it may only be inflammation exudation, followed by ulceration, old and not good, the worse, the worse, the deeper and deeper, and eventually the whole layer of the skin is rotten. The skin around the ulcer is affected, atrophy occurs, the color is black, causing eczema, and from time to time desquamation, itching. In front of the lower part of the lower leg, the skin is the bone. Once the ulcer occurs, the bone is exposed, and the surface is infected with it, forming chronic osteomyelitis. Some patients have been unhealed for several years and more than ten years.
Congenital factors (35%):
Some people have weak natural vein walls, or the number of diaphragms in the veins is too small, the structure is poor, and the function is poor. If the old standing still does not move, the muscle activity of the lower limbs is reduced, the muscle squeeze is insufficient, and the blood flow of the lower limbs is blocked. Causes an increase in intravenous pressure. After a long time, the superficial veins of the lower extremities expand and thicken, and then develop into a group, like a group of sputum in the skin. Patients often feel soreness and fatigue in the lower limbs, and some have edema in the back of the foot or ankle. If left untreated, the lower leg and ankle skin will shrink, become thinner, brighter, the hair is sparse, the color is darkened, eczema appears, and ulcers occur.
Arteriovenous pressure difference (35%):
Humans are walking upright, and the venous flow of the lower extremities must be overcome by a large amount of gravity. The mystery is mainly the pressure difference between the artery and the vein. The former has high pressure, the latter has low pressure, and the direction of blood flow naturally goes from high to low.
Physical factors (30%):
The squeezing effect of muscle contraction during lower limb activity, long-term stimulation can also cause the disease to occur.
Prevention
Old rotten leg prevention
The key steps to prevent old rotten legs are as follows:
1. Prevention of old rotten legs must first be treated early, clear diagnosis and treatment, maintenance and improvement of venous return, clear tissue congestion. If there is a history of venous ulcers. Deep vein thrombophlebitis and venous insufficiency. More should be actively treated. Prevent the disease from developing and aggravating.
2. Avoid a long position to prevent the old rotten legs from sitting for a long time. When the body is standing still or sitting for a long time. Blood is affected by gravity. The pressure on the venous valve of the lower extremity is greater. The calf muscles are in a relatively relaxed state. Poor blood drainage in the venous lumen. The valve continues to withstand greater pressure. When the pressure is greater than the pressure the valve is resisting. The blood in the veins is abnormally refluxed and gradually worsens. Eventually, local venous congestion is exacerbated. Therefore, you should avoid standing for a long time and should take appropriate rest and activities.
3. Prevent long-term increase in intra-abdominal pressure. Increased intra-abdominal pressure affects venous return of the lower extremities. Causes an increase in venous pressure in the lower extremities. Increased damage to the venous valve or increased burden on the venous valve. Therefore, active treatment of diseases that lead to increased intra-abdominal pressure can prevent old rotten legs.
4. Raise the affected limb and promote venous return of the lower extremity. Take appropriate rest and raise the affected limb. In order to promote blood return of the affected limb, it can reduce the swelling of the affected limb and prevent leg ulcers. The patient raised the affected limb. 3-5 times a day for half an hour. Encourage walking. Improve blood circulation to prevent old rotten legs.
5. Prevent trauma. Due to varicose veins, the vein wall is very thin, and it is easy to damage the rupture and bleeding. Therefore, it is necessary to pay attention to protect the affected limb, avoid traumatic frostbite or insect bite, and prevent old rotten legs.
6. Old rotten legs combined with eczema. If combined with eczema should be treated promptly. Avoid scratching the infection causing ulcers or worsening.
7. When the old rotten leg is treated, the diet should be light, eat less fish, shrimp and crab.
Complication
Old rotten leg complications Complications thromboangiitis obliterans
Complications of old rotten legs: In all chronic ulcers of the lower extremities, the proportion of ulcers caused by venous diseases is more than 90%, and the remaining less than 10% are arterial diseases, thromboangiitis obliterans, lymphatic obstruction, and nerves. Sexual diseases, metabolic disorders, blood system disorders and panniculitis.
Symptom
Old rotten leg symptoms common symptoms calf ulcer foot gangrene skin pale itching serous purulent discharge
The main symptoms are lower extremity pain and ulcers. From light to heavy, it can be characterized by intermittent claudication, lower extremity pain and foot gangrene.
The data showed that the early stage of the lesion showed that the skin of the foot was pale when the lower limbs were raised, the back of the foot was cold, the pulsation of the dorsal artery was weakened and disappeared, intermittent claudication, and then simply could not walk, the pain during walking was unbearable, and then there was a rest. It is also painful. In severe cases, the patient can sleep at night because of the pain.
The disease develops further, gangrene can occur on the lower limbs, especially on the feet, and the wounds are unhealed for a long time. The gangrene can be divided into three types: wet, dry and mixed. Those with severe gangrene have to undergo amputation and become disabled. If you have a history of diabetes for more than 5 years, you should see the above symptoms as soon as possible to the peripheral vascular department to avoid amputation.
Examine
Inspection of old rotten legs
"Four clinics" (ie, look, smell, ask, cut) are the basic methods for traditional medical examination of diseases in China, and are an important basis for clinical syndrome differentiation and treatment of traditional Chinese medicine.
Physical examination method: the main diagnostic basis is based on the incidence. These include limb pain, limb skin color and temperature, degree of swelling, migratory thrombophlebitis, limb dystrophy, arterial pulsation, ulcers and gangrene.
Color Doppler blood flow map is a non-invasive examination method, in addition to microcirculation examination, X-ray plain film examination, arteriovenography, CT examination, magnetic resonance angiography, blood coagulation examination and many other inspection methods.
Diagnosis
Old rotten leg diagnosis
Zero grade: no open lesions on the skin. Insufficient blood supply to the extremities, purplish or pale color, cold, numbness, dullness or loss of the limbs. Stinging or burning of the extremities, often accompanied by deformities of the toes or feet.
Level 1: There is an open lesion in the skin of the extremities. Superficial ulcers caused by blisters, blood blisters, corns or moles, frostbite or burns and other skin damage, but the lesions have not affected deep tissues.
Level 2: Infected lesions have invaded deep muscle tissue. Often mild cellulitis, multiple pus and sinus formation, or infection along the muscle space, resulting in foot, foot dorsal ulcer or gangrene, more purulent secretions, foot or toe skin focal Dry gangrene, but the tendon ligament is still not damaged.
Level 3: destruction of the tendon ligament tissue. Cellulitis combines to form a large abscess, purulent secretions and necrotic tissue, foot or a few toes dry gangrene, but bone destruction is not obvious.
Grade 4: Severe infection has caused bone destruction, osteomyelitis, bone and joint destruction or formation of pseudoarthrosis, and some toes or parts of the hands and feet have wet or dry severe gangrene or necrosis.
Grade 5: Most or all of the foot is infected or ischemic, resulting in severe wet or dry gangrene, blackening of the extremities, often affecting the ankle and calf.
