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9 - L’ulcera venosa<br />

lavorativa, riduzione del dolore locale, precoce ripresa della capacità deambulatoria,<br />

i parametri per valutare i risultati ottenuti. Riteniamo, pertanto, che<br />

qualunque strategia terapeutica si voglia attuare, non si può presc<strong>in</strong>dere dalla<br />

terapia medica e dalla compressione che favoriranno, quantitativamente e qualitativamente,<br />

il processo di guarigione e ridurranno il rischio delle recidive.<br />

BIBLIOGRAFIA:<br />

1. Collegio Italiano di <strong>Flebologia</strong>. L<strong>in</strong>ee guida diagnostico-terapeutiche delle malattie delle<br />

vene e dei l<strong>in</strong>fatici”. Acta Phlebologica, 2003; vol. 4: 29-31.<br />

2. Guarnera G. L’ulcera venosa: dalla cl<strong>in</strong>ica alla terapia. Litografia Saba Roma, 2006; pp.<br />

85-87, 105-107.<br />

3. Stegmann W, Hubner K, Deichmann B, Muller B. Efficacy of rutosides <strong>in</strong> the treatment of<br />

venous varicose ulce. Therapiewoche 1986; 36: 1828-33.<br />

4. Arosio E, Ferrari G, Santoro L et al. A placebo-contolled, double bl<strong>in</strong>d study of mesoglycan<br />

<strong>in</strong> the treatment of cronic venous ulcers. Eur J Endovasc Surg, 2001; 22: 365-72.<br />

5. Stemmer R. Teoria e pratica del trattamento elastocompressivo. Chirurgia Vascolare di P.<br />

Belardi, Ed M<strong>in</strong>erva Medica; vol II cap. 48: 575-93.<br />

6. Partsc H. Compressiontherapy therapy of legs. J Dermatol. Surg. Oncol, 1991; 17: 799-<br />

805.<br />

7. Fletcher A, Cullum N, Sheldon TA. A systematic review of compression treatment for<br />

venous leg ulcers. BMJ, 1997; 315, 576-80.<br />

8. Stemmer R, Marescaux J, Furderer C. Il trattamento compressive degli arti <strong>in</strong>feriori, <strong>in</strong><br />

particolare mediante calze e collant di contenimento. Der Hautarzt, 1980; 31: 355-65.<br />

9. Allegra C. The role of the microcirculation <strong>in</strong> venous ulcers. Phlebol<strong>in</strong>fology, 1994; 2: 3-8.<br />

10. Emter M. Modification du flux sangu<strong>in</strong>e dans le ve<strong>in</strong>es des members <strong>in</strong>férieurs aprés compression.<br />

Phlébologie, 1991: 44 (2): 481-484.<br />

196<br />

ABSTRACT:<br />

9.2 - La copertura dell’ulcera.<br />

Nebbioso G.<br />

9.2 - La copertura dell’ulcera<br />

The leg ulcers have an annual <strong>in</strong>cidence <strong>in</strong> the adult population of about<br />

1%, which reaches 3,6% <strong>in</strong> <strong>in</strong>dividuals older than 65 years 1 .<br />

Ulcers, sores, were once regarded as someth<strong>in</strong>g shameful, just decent, to<br />

hide, from which the term “cover the ulcer”. Today, “cove<strong>in</strong>g” means to<br />

dress the wound and to create all the optimal conditions for heal<strong>in</strong>g.<br />

Cure an <strong>in</strong>jury, time, meant to dry the wound, heal<strong>in</strong>g it “<strong>in</strong> the crust”;<br />

but this concept has been completely reversed by W<strong>in</strong>ter, who, <strong>in</strong> 1962,<br />

<strong>in</strong>troduced the concept of moist wound heal<strong>in</strong>g.<br />

The concept of dress<strong>in</strong>g has suffered <strong>in</strong> recent years a complex<br />

metamorphosis.<br />

From a dress<strong>in</strong>g that did not <strong>in</strong>terfere with the processes of tissue repair, we<br />

went to phisician who tried to establish an environment (wet) more favorable<br />

to the tissue repair process, until you arrive to the dress<strong>in</strong>g techniques<br />

that seek to restore a proper balance of biochemical and cellular <strong>in</strong>jury<br />

(i.e., platelet gels, dress<strong>in</strong>gs based on hyaluronic acid and collagen). The<br />

achievement, through appropriate medication, of these goals is essential,<br />

because you can obta<strong>in</strong> to the ulcer heal<strong>in</strong>g<br />

INTRODUZIONE:<br />

Le ulcere degli arti <strong>in</strong>feriori presentano un’<strong>in</strong>cidenza annuale nella<br />

popolazione adulta di circa l’1% che raggiunge il 3,6% negli <strong>in</strong>dividui con<br />

più di 65 anni 1 .<br />

Le ulcere, le piaghe, un tempo venivano considerate come un qualcosa di<br />

vergognoso, di poco dignitoso, da nascondere, da cui il term<strong>in</strong>e “coprire<br />

l’ulcera”. Oggigiorno, “coprire” significa medicare la lesione e creare tutte<br />

197

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