Old rotten leg

　　The disease commonly known as 'old rotten leg' in the folk is mainly chronic skin ulceration in the middle and lower part of the calf. At the beginning of the disease, it may be just inflammation and exudation, followed by the formation of ulcers that do not heal, becoming larger and deeper over time, eventually destroying the full layer of the skin. The skin around the ulcer is affected, leading to atrophy, darkening of color, and the occurrence of eczema, with frequent desquamation and itching. In front of the middle and lower part of the calf, the subcutaneous tissue is bone. Once an ulcer occurs, the bone is exposed, and the surface becomes infected, leading to chronic osteomyelitis. Some patients may suffer from this disease for several or even ten years without cure, enduring great suffering.

　　Humans are upright walkers, and the venous blood flow in the lower limbs must overcome a significant gravitational pull. The mystery mainly lies in the pressure difference between arteries and veins. The former has high pressure, while the latter has low pressure, and the blood flow naturally flows from high to low. In addition, there is the squeezing effect of muscle contraction during lower limb movement, as well as the static membrane valves inside the veins. Some people are born with weak vein walls, or have too few valves with poor structure and function; if they stand still for a long time, the activity of the lower limb muscles decreases, the squeezing effect is insufficient, and the venous blood return in the lower limbs is obstructed, leading to increased venous pressure. Over time, the superficial veins in the lower limbs become dilated and thickened, and further development leads to them twisting into lumps, resembling a mass of earthworms coiled under the skin. Patients often feel acidity and swelling in the lower limbs, and some may have edema in the back of the feet or ankles. If untreated, the skin below the calf and ankles will become atrophic, thin, shiny, with sparse hair and darkened color, and eczema may appear, leading to ulcers.

　　Among all chronic ulcers of the lower extremities, over 90% are caused by venous diseases, and the remaining less than 10% are caused by arterial diseases, thromboangiitis obliterans, lymphatic obstruction, and neurological diseases, metabolic disorders, blood system disorders, and lipodermatosclerosis, etc.

　　The main symptoms are pain and ulcers in the lower extremities, which can manifest from mild to severe, including intermittent claudication, rest pain in the lower extremities, and gangrene of the feet.

　　Data shows that in the early stage of the disease, the symptoms may include pale skin on the feet, coolness of the foot back, weakened and eventually absent foot back artery pulsation, intermittent claudication, and eventually being unable to walk. Walking is painful, and later, pain may also occur during rest. In severe cases, patients may suffer from insomnia due to the inability to bear the pain.

　　If the condition progresses further, gangrene may appear in the lower extremities, especially on the feet, with unhealed wounds. Gangrene can be classified into three types: wet, dry, and mixed. Severe gangrene may require amputation, resulting in disability. If there is a history of diabetes for more than 5 years and the above symptoms appear, seek medical attention in the department of peripheral vascular diseases as soon as possible to avoid amputation.

　　1, To prevent chronic venous insufficiency, it is essential to seek medical attention early, clarify the diagnosis and treatment, and maintain and improve the smooth flow of venous return, and clear the tissue congestion. If there is a history of venous ulcers, deep vein thrombophlebitis, or incomplete venous valve function, more active treatment should be carried out to prevent the progression and exacerbation of the condition.

　　2, Avoid prolonged standing or sitting in one position to prevent chronic venous insufficiency. When the human body is in a static standing or sitting position for a long time, blood is affected by gravity, causing a greater pressure on the venous valves in the lower extremities. The calf muscles are in a relatively relaxed state. The blood in the venous lumen is not emptied properly. The valves continuously bear a greater pressure. When the pressure exceeds the pressure that the valves can resist, the blood in the veins flows abnormally and gradually worsens. Ultimately, it causes local venous congestion to worsen. Therefore, it is necessary to avoid prolonged standing or sitting and to take appropriate rest and activity.

　　3, Prevent the long-term increase in intra-abdominal pressure. The increase in intra-abdominal pressure affects the return of venous blood in the lower extremities, causing an increase in venous pressure in the lower extremities. It increases the destruction of venous valves or加重 the burden on the venous valves. Therefore, actively treating diseases that increase intra-abdominal pressure can prevent chronic venous insufficiency.

　　4, Elevate the affected limb to promote the return of venous blood in the lower extremities. Take appropriate rest and elevate the affected limb to promote blood return in the affected limb, which can reduce swelling and prevent ulceration of the lower leg. The patient should elevate the affected limb. It is appropriate to do this 3-5 times a day for half an hour. Encourage walking. Improving blood circulation can prevent chronic venous insufficiency.

　　5, Prevent外伤. Due to the tortuous veins, the venous wall is very thin and easily damaged, leading to bleeding. Therefore, it is necessary to protect the affected limb, avoid injuries, frostbite, or bites by animals, which can prevent chronic venous insufficiency.

　　6, The chronic venous insufficiency may be accompanied by eczema. If eczema occurs, it should be treated promptly to avoid breaking the skin and causing ulcers or exacerbating the condition.

　　7. During the treatment of chronic ulcers, the diet should be light and avoid eating fish, shrimp, and crabs.

　　1. 'Four Inspections'

　　It is a basic method of disease diagnosis in traditional Chinese medicine and an important basis for clinical differential diagnosis and treatment in traditional Chinese medicine.

　　2. Physical Examination Methods

　　The diagnosis is mainly based on the condition of onset. This includes limb pain, limb skin color and temperature, degree of swelling, migratory thrombophlebitis, limb nutritional disorders, arterial pulsation, ulcers, and gangrene, etc.

　　1. Abstain from spicy foods such as chili, soy sauce, chili oil, Sichuan pepper, curry, chives, garlic sprouts, mustard, etc., as they can promote blood circulation and increase dampness within the body, causing inflammation to spread after consumption.

　　2. Abstain from seafood, as it can trigger the initial stage of ulcers and is not suitable for consumption.

　　3. Abstain from fried, grilled, and high-fat foods, as they can worsen the condition.

　　4. Abstain from hot foods such as lamb, deer meat, garlic, etc., as they can make ulcers difficult to heal.

　　5. Abstain from alcohol, as it can enlarge the ulcer surface and spread bacterial infection.

　　1. Compression Therapy

　　Use elastic stockings to reduce edema during exercise by applying external pressure. If the patient has leg ulcers due to venous hypertension, they should follow the doctor's advice to take antibiotics and diuretics and use special medical materials for treatment.

　　2. Sclerosing Agent Therapy

　　Inject a hypertonic solution (such as high-concentration saline or sclerosing agent) into the varicose veins to destroy the vascular intima, causing it to close and disappear after healing. However, it can only treat small varicose veins, and there may be severe pain, pigmentation, even inflammation, swelling, and ulceration during treatment, and there is a tendency to recur and be difficult to handle after recurrence, so it is only suitable for a few patients with chronic ulcers.

　　3. Endovenous Laser Closure of Great Saphenous Vein

　　EVLT is currently an advanced international minimally invasive vascular surgical treatment technology. By puncturing into the vascular cavity, applying the characteristics of semiconductor laser conduction, and transmitting laser through optical fibers, it can achieve the precise destruction of the vascular intima, leading to the treatment goal of venous fibrosis and vascular closure.