Chronic wounds in the elderly Flashcards
what is the most common cause of chronic leg ulcers?
venous ulcers due to venous hypertension
how do we treat venous ulcers?
compression = mainstay
but also exercise, varicose vein surgery, moist dressings
what pressure for compression stockings do we use for chronic venous insufficiency
25-35mmHg
before commencing compression stockings, what would you need to check?
vascular status- check pedal pulses, do a ABI/toe pressure
what ABI reading is suggestive of PVD?
less than 0.8
if you get a high ABI reading, greater than 1.2, what does this indicate?
calcified vessels
what toe pressure do you need for the ability for venous ulcers to heal?
greater than 60mmHg supine
why do we need to determine the stage of infection e.g. biofilm/colonisation as compared to localised infection?
determines treatment
colonisation- local topical therapy
infection- systemic antis etc
gold standard for investigation of a chronic wound?
biopsy but not used very much for obvious reasons
Describe the levine technique for wound swabbing
best concordance with biopsy
- thoroughly clean wound
- roll swab tip over 1cm2 of cleansed granulation tissue
- adequate pressure for wound fluid
Intrinsic risk factors for pressure ulcers?
advanced age malnutrition impaired mobility severe illness neurological deficits
most common areas to find a pressure ulcer?
heels and sacrum
how many stages are there in pressure ulcer staging?
stage 1-4 (1= intact skin with ‘unblanchable’ redness, 4= full thickness)
what is the most evidence based practice for preventing pressure ulcers?
pressure relieving mattress
if you suspect the wound is vasculitis e.g. livedo reticularis, what ix do you need to do?
biopsy
