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Venous, arterial and diabetic ulcers

Texts and images (c) Ligamed

Venous ulcus cruris
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The venous leg ulcer is typically a very heavily weeping wound. The main problem is to absorb large amounts of exudate and channel it so that it does not overflow to the wound edges. 

The heavily weeping wound is filled with LIGASANO® white and also covered with LIGASANO® white, overlapping the wound edges by at least 2 cm. If the change is made in good time, the overflow of the wound edges is counteracted. Excess exudate is absorbed. It may be advisable to use additional superabsorbents. 

The accompanying treatment (compression bandage, compression stocking) is carried out as usual.

Arterial ulcus cruris
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Consequences of arterial circulatory disorders usually begin below the knee. If there is no arterial occlusion, the LIGASANO® bandage can provide valuable services. 

The leg or foot lesion is locally treated with LIGASANO® white. The circulation-promoting effect is produced by the LIGASANO® bandage (300x10x0.3 cm). 

The LIGASANO® bandage is applied in 5 or 10 cm width like a normal padded bandage. They achieve both padding and stimulation of blood circulation at the same time. The LIGASANO® bandage does not tend to slip, but can be fixed with a mesh tube or better with LIGAMED® Fix if required. 

Ulcus cruris mixtum
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The arterial venous leg ulcer is particularly difficult to treat because on the one hand the necessary blood inflow is missing and on the other hand it is hindered by compression measures due to the lack of outflow. 

The wound, which usually weeps, is filled with LIGASANO® white and also with LIGASANO® white. The wound edges are covered with at least 2 cm of overlap. If the change is made in good time, the overflow of the wound edges is counteracted. 

The LIGASANO® bandage is applied 5 or 10 cm wide like a normal padded bandage under the compression bandage or stocking. They achieve cushioning and blood circulation at the same time.

Case report 1 -
Wound treatment with LIGASANO® in Achilles heel ulcers

Patient data and anamnesis:

71-year-old patient, diabetic type II since 2013, insulin-dependent since 12/2014, diabetic neuropathy, apoplexy 2014, hemiparesis right, dependent on wheelchair; very good domestic situation; cared by the wife; she also connects the wound.

Wound description:

Ulcus over the right Achilles heel since 10/2015, probably pushed at the wheelchair. Therapy from 10/2015 - 30.03.2016: Until 11/2015: hydrogel; fatty gauze (Lomatüll), 12/2015: started with medical honey, 12/2015: started with Silvercell, 01/2016: again hydrogel from Hartmann, 02/2016: further with Silvercell (granulation at the wound edge), beginning of 03/2016: change to foam with adhesive edge (Aquacel Foam) Wound condition on 06. September, 2010: the wound was in a state of flux.04.2016: Wound fissured, inflamed, with fibrin coatings, partial granulation; little wound odour; wound surface: approx. 12 cm long, 5 cm wide, 0.5 cm deep, skin in wound area dry and scaly, hardly any pain, but sensitive to touch.

The patient today has an appointment in the practice of Dr. Jecht, conversion to LIGASANO®, ulcer has remained unchanged with previous treatment; wound size and signs of inflammation have rather increased. Wound cleansing with Prontosan wound irrigation solution, wound base Prontosan wound gel X, dressing material: LIGASANO® white sterile stick 6 x 2.5 x 0.4 cm, LIGASANO® white sterile wound dressing 10 x 10 x 1 cm, LIGASANO® white non-sterile bandage 300 x 10 x 0.3 cm.

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Fig. 1: 06.04.2016: Wound condition before the start of treatment with LIGASANO® white

Fig. 2: 20.04.2016: Wound size now 11 x 5 x 0.5 cm, less plaque, otherwise unchanged

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Fig. 3: On 10..05.2016 the wound looks much better, further reduction of plaque.

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Fig. 4: 10.05.2016 wound cleaning and wound dressing as before, no change in therapy.

Fig. 5: On 01.06.2016 the wound is flatter overall and shows several islands of granulation.

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Fig. 6: 01.06.2016 wound cleaning and wound dressing unchanged.

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Fig. 7: 22.06.2016: The wound has continued to decrease in area and depth and is completely granulated.

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Fig. 8: 13.07.2016: Wound size now 3x1x 0.2 cm, little exudate, further slow granulation and epithelization, good healing in general.

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Fig. 9: 15.11.2016: wound completely healed.

Authors: Astrid Kliem, nurse, ICW wound expert, Berlin, Dr. medical Michael Hecht, Havelhöhe Hospital, Berlin and Susanne Hagen, specialist nurse, ICW wound expert

(c) Ligamed

Ulcer treatment in the ankle or lower leg area

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