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    Dear Pods.

    I saw a 60 yo man who has some scarring under his medial malleoli right foot . There is some venous stasis in the area due to an injury to the lower leg and he is on his feet all day in labouring type work. He told me his Pedometer shows up to around 30,000 steps daily.

    This site periodically develops an ulcer which is dressed /pressure bandage applied and heals up. The skin when healed becomes dry and rough . He found when the skin is soft, it doesn't seem to break down.
    He noticed that when he used a Cortisone cream the skin stayed soft, but was advised not to use this long term.

    As well as pressure relief in footwear, any ideas for alternative emollients. I suggested the creams containing urea for use on the site, once it has healed. He was using aqueous creams ie Sorbelene but it wasn't effective for this problem

    thanks Jill
     
  2. gangrene1

    gangrene1 Active Member

    If a person is getting recurrent venous ulcers, he should be wearing a pair of compression stockings daily.

    Maybe he can try Secura cream by Smith and Nephew as a form of skin protectant.
     
  3. drsarbes

    drsarbes Well-Known Member

    Hi Jillian:
    Recurrent stasis ulcers are difficult to treat.
    As you know, they stem from poor perforators which connect deep to superficial venous systems. The skin becomes atrophic and any minor trauma will often lead to ulceration. Medial lower leg is a common location.
    I would advise against Corticosteroid application as this will only lead to further atrophy of the skin and impair granulation.
    Treatment of choice is compression bandage with concomitant control of edema (antiembolic type stockings, elevation, lifestyle changes). Unna's boot dressing help the skin AND the edema and are a good choice of bandage for open ulcers. Be sure added compression is directed to the area overlying the ulcer itself.
    Surgical intervention for removal of superficial and perforators may be indicated.
    Good luck
    Steve
     
  4. Ella Hurrell

    Ella Hurrell Active Member

    We sometimes advise Epaderm in this sort of case. It can be used as a wash/soap alternative also. I'm not sure if the brand names will be the same in all countries though. Perhaps the GP will prescribe something?

    Ella
     
  5. Thanks a lot everyone. Isn't this a great thing , being able to get help/advice so promptly. I certainly appreciate it. Cheers Jill
     

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