12
LEG ULCER: A CHALLENGING CONDITION
ÚLCERA EN LA PIERNA: UNA CONDICIÓN DESAFIANTE
Dos Santos Modesto Vitorino1,2*, Modesto Campos Julia2
Abstract
1 Armed Forces Hospital. Brasília – DF, Brazil.
2 Catholic University of Brasília, Medical Course.
Brasília – DF, Brazil.
Lower limb, pressure and neoplastic ulcers can be complications of
circulatory, neurological and metabolic disorders of aging. Health care
must assess the quality and not only the quantity of life of these patients.
Therefore, non-specialist professionals need to obtain adequate prior
training to deal with these injuries. The aim of these comments is to
emphasize the training of primary health care workers on the diagnosis
and management of leg ulcers in low- and medium-income countries.
Herein are included a very recent Ecuadorian and two previous Brazilian
manuscripts. The main factors related to etiology, management and
prognosis are commented on.
Resumen
Úlceras en miembros inferiores, por presión y neoplásicas pueden
ser complicaciones de alteraciones circulatorias, neurológicas y
metabólicas del envejecimiento. La asistencia sanitaria debe valorar
la calidad y no solo la cantidad de vida de estos pacientes. Por lo
tanto, los profesionales no especialistas deben obtener una formación
previa adecuada para hacer frente a estas lesiones. El objetivo de
estos comentarios es enfatizar la formación de los trabajadores de
la atención primaria de salud en el diagnóstico y tratamiento de las
úlceras de las piernas en los países de ingresos bajos y medios. Aquí
se incluyen un manuscrito ecuatoriano muy reciente y dos brasileños
anteriores. Se comentan los principales factores relacionados con la
etiología, el manejo y el pronóstico.
Dear Editor:
Ulcers affecting the lower limbs constitute a frequent cause of outpatient
attention in primary care settings mainly in individuals with comorbidities,
and these patients are more often evaluated and managed by non-
specialized professionals. (1,2) Malignancies may develop at the site
of burn scars and non-healing chronic ulcers, and late diagnosis or
misdiagnosis can propitiate the occurrence of severe outcomes. (2)
Rosero Arboleda and Loor Zambrano commented on the role of primary
care for lower limb ulcers, involving possible diagnostic failures and
lack of specialized care (1). They reported an 86 year-old woman with
hypertension, diabetes type 2, and a healed wound of the right leg,
which after local trauma evolved as an irregular, painful ulcer without
signs of infection. The lesion was managed by a family doctor in a
primary care ofce, and also a vascular surgeon through telemedicine,
with the healing in 9 months. The authors focused on comorbidities,
longstanding course, and the 30% of recidivism in this condition, which
includes venous, arterial, neuropathic, and malignant causes; besides
the importance of early signs of infection and unidentied foreign
body (1). They accented the need for individualized management of
these ulcers by debridement, irrigation, dressings, bandages, alginate,
hydrocolloid, corticosteroids, antimicrobials, analgesics, avonoids,
troxerutin, glycosaminoglycans, and pentoxifylline, and control of
Revista Médica Vozandes
Volumen 32, Número 2, 2021
* Corresponding author:
Vitorino Modesto dos Santos
E-mail: vitorinomodesto@gmail.com.
Key words: Diagnosis; Leg ulcer; Quality of life; Treatment.
Palabras clave: Diagnóstico; Úlcera de la pierna; Calidad de vida; Tratamiento.
Forma de citar este artículo: Santos
VM, Modesto JC. LEG ULCER: A
CHALLENGING CONDITION. Rev Med
Vozandes. 2021; 32 (2): 12 - 13
ORCID ID:
Vitorino Modesto dos Santos
orcid.org/0000-0002-7033-6074.
Julia Campos Modesto
orcid.org/0000-0002-9286-5372.
LETTER TO EDITOR
Conflict of interest: The authors declare no
conict of interest.
Financial disclosure: The authors have no nan-
cial relationships relevant to this article to disclose.
Este artículo está bajo una
licencia de Creative Com-
mons de tipo Reconocimien-
to – No comercial – Sin obras
derivadas 4.0 International.
DOI: 10.48018/rmv.v32.i2.1
Received: 06 – Jun – 2021
Accepted: 22 – Ago – 2021
Publish: 20 – Dic – 2021