I believe that the term “old rotten feet” is not unfamiliar to the general public, especially the elderly. You can often see patients with “old rotten feet” complaining of broken skin, difficult to heal, increasingly large wounds, thick yellow water, some people have a bad smell, and eventually the entire foot blackened and necrotic, to the point of requiring amputation. And this problem is not so simple to treat, it is not easy to control the infection, one is not careful, not long after the relapse. Why a common disease, but many doctors and patients headache? Shanghai Changhai Hospital Vascular Surgery Department Tian Wen Why old rotten feet are difficult to treat To be precise, “old rotten feet” is not a disease, it is the people’s collective name for the lower limbs, foot rupture disease. In medicine, arterial, venous, lymphatic and other diseases can all cause long-term foot infection. Many “old rotten feet” long-term hospitalization but difficult to cure; or temporary relief, a little carelessness and aggravated again, because only for the “table”, but not for the “root” for The reason is that the treatment is only for the “surface” but not for the “root”. It seems to be the surface of the skin ulceration, infection, for the surface of the cleaning, change of medicine can indeed play a role in relieving the symptoms; but its root cause is in the blood vessels, if not for the treatment of blood vessels, the wound is difficult to heal, even if the temporary healing is easy to recur. How to distinguish between “arterial rotten feet” and “venous rotten feet” The root cause of rotten feet lies in blood vessels, but the treatment for blood vessels is not static, because the causes of “rotten feet” are There are two types of vascular diseases: “arterial” and “venous”, and their treatments are completely different. “Arterial” refers to the skin necrosis, ulceration and infection caused by the lack of narrowing and occlusion of the arteries in the lower extremities, which is usually more common in diabetic patients, and the skin is easily infected after ulceration, often accompanied by bad odor, and is often called “diabetic foot”; “Venous” refers to the lower extremity bruising lesions caused by venous insufficiency of the lower extremity, usually accompanied by lower extremity edema, blackening, skin sclerosis and other manifestations. Both diseases eventually manifest as skin breakdown and persistent healing, but there are differences in root causes and symptoms. Except for a very small number of patients, the two types of lesions do not usually coexist. How to treat “old rotten feet” When the cause is found, treatment should be directed at the cause. Treatment is divided into two aspects: “surface” and “root”. Treatment of the “surface” refers to the treatment of the skin breakdown itself, which is also a common measure such as debridement and drug exchange, with the aim of controlling the infection; the “root” requires treatment of the internal cause, changing the vascular condition. For arterial rotten feet, the “root” lies in improving the blood circulation in the lesioned area. First of all, systemic diseases should be controlled. Diabetic patients should first control their blood sugar, and people with high blood lipids should control their blood lipids. The improvement of blood supply to the lower extremities can be achieved by both medication and surgery. Surgery includes both open surgery and minimally invasive methods, both of which aim to open up an occluded artery or build another channel for blood supply. Medications are usually the most important supplement to surgery, but in less severe cases, medications alone may also be useful. In the case of venous clubfoot, the “essence” is to improve venous return and reduce venous pressure in the lower extremities. This can be done through physical, surgical and medication treatments. Physical therapy includes: 1. Elevate the lower extremity to promote venous return. 2.Stroke the leg with the hand from the ankle upward to promote the edema to subside and reduce the venous pressure. 3.Wearing elastic stockings to assist venous function. For patients with varicose veins, the superficial varicose veins and the traffic veins can be surgically stripped. The purpose of the medication is to improve the function of the vein wall, reduce exudation and promote reabsorption.