Treatment of crural ulcers consists of:
- Debridement.
- Application of pharmaceutical products.
- Wound dressing.
Debridement involves removing crusts and necrotic tissue from the wound. This can be done mechanically (scissors and tweezers, wet gauzes, rinsing with 0.9% NaCl or 3% H2O3), chemically using enzymes or by autolytic debridement using physiological proteolytic enzymes.
The skin around the sore can be protected by applying pharmaceutical products, such as zinc oxide – Vaseline ointment. There are various ways to treat the sore itself. It is important that the applied products are as inert as possible.
A number of (non-standard) preparations are listed below:
- Zinc oxide – Vaseline paste.
- Zinc oxide – Vaseline ointment.
- Ointment gauze dressing.
- Aqueous solution of 1% gentian violet (cacogenic eczema).
In the case of bacterial infection, the following can be used after culturing:
- 3% Vioform in zinc oxide ointment.
- 1% silver Sulfadiazine.
- 0.5 g pulverised KMn04 dissolved in 2000 cc H2O.
- Sulphur, dusted over sore 6 times daily (or applied as wet dressing in case of ulcerating sore).
Eczema may develop around the sore (epidermal dermatitis) due to contact allergy to Lanolin and Eucerin. This should be treated with a preparation of 1% hydrocortisone in zinc oxide Vaseline ointment. The dressing should include a dressing layer and a fixing layer. Finally, a pressure-gradient bandage should be applied.