Hansson C
Dermatology Division, Sahlgrenska Hospital, University of Göteborg, Sweden.
Drugs Aging. 1994 Nov;5(5):323-34. doi: 10.2165/00002512-199405050-00002.
In elderly patients, even those with a typical venous (stasis) ulcer, coexisting conditions like peripheral arterial insufficiency and diabetes are very common. Therefore, all elderly patients with leg ulcers should have a complete medical assessment. The mainstay of treatment for venous ulcers is compression therapy, exercise and leg elevation at rest. Long term treatment with double bandages (zinc paste bandages and elastic compression), changed once weekly, is the recommended standard treatment in the elderly. Hydrocolloid dressings are also suitable for long term treatment in clean ulcers, and should be changed once or twice weekly and combined with compression. Sloughy, exudating ulcers might need redressing daily with a desloughing agent for a short period of time. The risk of sensitising patients with chronic leg ulcers is high and few topical preparations, with low antigenicity, should be used. Infection and ulcerated skin cancers should be ruled out in nonhealing ulcers if the patient complies with compression therapy. After healing, the patient should be advised to continue compression therapy with stockings to prevent recurrences. New noninvasive techniques for investigation of venous insufficiency can select patients suitable for venous surgery, but many elderly patients are not interested in surgery or have other ailments that prevent surgery.
在老年患者中，即使是那些患有典型静脉（淤滞）溃疡的患者，外周动脉供血不足和糖尿病等并存疾病也非常常见。因此，所有患有腿部溃疡的老年患者都应进行全面的医学评估。静脉溃疡治疗的主要方法是压迫疗法、运动以及休息时抬高腿部。双层绷带（锌糊绷带和弹性压迫绷带）每周更换一次的长期治疗是老年患者推荐的标准治疗方法。水胶体敷料也适用于清洁溃疡的长期治疗，应每周更换一至两次，并结合压迫疗法。有腐肉、渗液的溃疡可能需要短期内每天用去腐剂换药。慢性腿部溃疡患者发生过敏的风险很高，应使用抗原性低的局部制剂。如果患者接受压迫疗法，对于不愈合的溃疡应排除感染和溃疡性皮肤癌。溃疡愈合后，应建议患者继续使用弹力袜进行压迫治疗以防止复发。用于研究静脉功能不全的新的非侵入性技术可以筛选出适合静脉手术的患者，但许多老年患者对手术不感兴趣或有其他妨碍手术的疾病。
