Therapeutic target
Pain relief and healing
Therapy recommendations
- See under surgical therapy
- Support of healing (platelet aggregation inhibitors, rheologics, prostaglandins; flavonoids such as diosmin/hesperidin combo; coumarin/troxerutin combo; sulodexide; horse chestnut extract); drug therapy alone will not be successful
- Substitution of trace elements (iron, selenium, zinc) and vitamins (vitamin C, folate)/if necessary, taking a dietary supplement for skin, hair and nails; if necessary, also additional supply of protein (a nutritional analysis is recommended).
- Analgesia (analgesics / painkillers).
- See also under “Further therapy“.
Support the healing of the ulcer
Active ingredients (main indication).
The following agents may be used as adjuncts to help heal the ulcer:
- Antiplatelet agents (TAH): acetylsalicylic acid (ASA) 300 mg/dOral treatment with 150 mg acetylsalicylic acid in addition to compression therapy as standard treatment was not convincing in a study that was double-blind and placebo-controlled: Time to recovery was almost the same in both groups (median with ASA 77 days; placebo group 69 days (hazard ratio [HR]: 0.85; 95% confidence interval: 0.64-1.13); p = 0.25 difference not significant.
- Rheologic agent (substance that improves blood flow properties, methylxanthine derivative). Pentoxyphylline 1,200 mg/d; CI in severe hepatic/renal insufficiency.
- Prostacyclin derivative iloprost 2 ng/kg bw/min as infusion; over 3 weeks, 5 d of therapy each, then 2 d rest.
- Prostaglandin E1 60 μg/d for 6 weeks.
- Flavonoids such as diosmin/hesperidin combo; coumarin/troxerutin combo; sulodexide 600 E i. m. once/ 60 mg i. m.for 20 d, then 2 x 500 mg/d p. o. until healing; horse chestnut extract.
- Substitution of trace elements (iron, selenium, zinc) and vitamins (vitamin C, folate) in deficiency states by means of a dietary supplement.
