Author/Editor		Vrabič, Erik
Title		Operativno zdravljenje golenje razjede
Translated title		Operative treatment of chronic leg ulcer
Type		članek
Source		Družinska medicina
Vol. and No.		Letnik 4, št. Suppl 5
Publication year		2006
Volume		str. 120-3
Language		slo
Abstract		Like any other chronic lesion, chronic leg ulcers require long-term treatment that is associated with great cost, and is frequently not very popular. The pathology of chronic leg ulcer is seen by specialists in various fields of medicine as well as by experts in related fields. Sometimes a surgical intervention is called for immediately upon the occurrence of the lesion, when removal of the necrotic tissue and drainage of abscess cavity and sinus is required. With suitable treatment, ulcers - at least those occurring in mild to moderate vascular changes in the leg - heal spontaneously by an increase in granulation tissue and gradual epithelization of the rims. Frequently, however, a surgical procedure is the only means of attaining at least a temporary, and sometimes even permanent reconstruction of chronic lesions. Plastic surgeons perform the majority of reconstructive procedures, and reconstructions of chronic leg ulcers are no exception. Minor lesions can often be closed directly. The simplest reconstructive method for larger soft tissue defects is by means of free skin grafts. An adequate surface is the precondition for the success of this procedure. Flaps are used to reconstruct deep defects and those with significant structures, such as vessels, nerves, joints, bones and tendons, exposed at their base.
Summary		Zdravljenje golenje razjede je tako kot zdravljenje vseh kroničnih ran dolgotrajno, povezano z velikimi materialnimi stroški in mnogokrat ne najbolj popularno. S patologijo golenje razjede se srečujejo številne medicinske specialnosti in tudi strokovnjaki sorodnih strok. Kirurško ukrepanje je včasih potrebno že takoj na začetku nastajanja kronične rane, ko je potrebno odstraniti mrtvo tkivo in drenirati abscesne votline ter sinusne trakove. Ob ustrezni negi lahko razjede, vsaj tisle, ki nastajajo pri blagih in srednje močno izraženih venskih spremembah goleni, zacelijo spontano s porastom granulacijskega tkiva in postopno epitelizacijo z robov. Mnogokrat pa lahko dosežemo vsaj začasno ali pa tudi dokončno rekonstrukcijo kroničnih ran le z operativnim posegom. Tako kot z večino rekonstrukcijskih posegov se tudi z rekonstrukcijo golenjih razjed v glavnem ukvarjajo plastični kirurgi. Manjše rane lahko mnogokrat zapremo neposredno. Najenostavnejša rekonstrukcija večjih defektov mehkih tkiv je s pomočjo prostih kožnih presadkov. Za uspešen način takšne rekonstrukcije je potrebna ustrezna podlaga. Globoke defekte in tiste, ki imajo na dnu izpostavljene pomembne strukture, kot so žile, živci, sklepi, kosti in tetive rekonstruiramo s pomočjo režnjev.
Descriptors		LEG ULCER SURGICAL FLAPS MICROSURGERY