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Physikalische Therapien des chronischen Ulcus cruris

Physical treatment modalities for chronic leg ulcers

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Zusammenfassung

Für die Behandlung des chronischen Ulcus cruris stehen zunehmend zahlreiche physikalische Behandlungsoptionen zur Verfügung. Daher werden im Rahmen dieses Übersichtsbeitrags Verfahren zu Kompressionstherapien, therapeutischem Ultraschall, Vakuumtherapien, extrakorporalen Stoßwellentherapien, Elektrostimulationstherapien, elektromagnetischen Therapien, photodynamischen Therapien, wassergefilterter Infrarot-A-Strahlung und Hydrotherapien im Hinblick auf ihren praktischen Einsatz und die zugrunde liegende Evidenz besprochen. Mit Ausnahme der Kompressionstherapie liegt für die meisten dieser Therapieverfahren keine gute wissenschaftliche Datenlage vor. Dies ist allerdings ein in der Wundbehandlung weitverbreitetes Problem. Dennoch gehören mehrere der beschriebenen Methoden, wie beispielsweise die Vakuumtherapien, heute zum Goldstandard der praktischen Behandlung von Patienten mit einem chronischen Ulcus cruris.

Auch wenn der Einsatz verschiedener der vorgestellten physikalischen Behandlungsmethoden die Abheilung der chronischen Wunden bei Patienten mit Ulcus cruris unterstützen kann, so ist doch insbesondere die Diagnostik und kausal ansetzende Therapie der zugrunde liegenden Ursachen für den dauerhaften Erfolg der Behandlung der Patienten von entscheidender Bedeutung.

Abstract

An increasing numbers of physical treatment options are available for chronic leg ulcer. In this review article, compression therapy, therapeutic ultrasound, negative pressure therapy, extracorporeal shock wave therapy, electrostimulation therapy, electromagnetic therapy, photodynamic therapy, water-filtered infrared-A-radiation and hydrotherapy are discussed in terms of their practical applications and the underlying evidence. With the exception of compression therapy for most of these treatments, good scientific data are not available. However this is a widespread problem in the treatment of chronic wounds. Nevertheless, several of the described methods such as negative pressure therapy represent one of the gold standards in practical treatment of patients with chronic leg ulcers. Although the use of physical treatment modalities may improve healing in patients with chronic leg ulcers, the diagnosis and treatment of the underlying causes are essential for long-lasting success.

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  1. Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland

    J. Dissemond

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Dissemond, J. Physikalische Therapien des chronischen Ulcus cruris. Hautarzt 61, 387–396 (2010). https://doi.org/10.1007/s00105-009-1882-2

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