Ulcers Chapter 8 Flashcards
Arterial vs venous…what is the difference?
- Aterial vs Venous Ulcers
- Round and smooth vs irregular
- Necrotic tissue vs no necrotic tissu
- No/weak pulse vs intact
- Diabetes/smoking vs thrombosis, poor venous valves
- Minimal drainage/yellow vs lot of drainage
- Inferior to ankle on lat and dorsal foot vs superior to medial malleolus and med aspect lower leg
- What disease might cause this?
Diabetes
15-46 more times more likely to develop ischemic ulcers
15% develop leg ulcers
12-24% amputation
Arterial insufficiency
- Cause???
Lack of
Result is gangrene
- Risk factors:
Smoking
Hereditary
Htn
Diabetes
Ischemic Ulcer
- Risk factors
- Hypercholesterolemia
- Atherosclerosis
- DM
- Peripheral neuropathy
- Reduced jt range
- Obesity
- Poor footwear
- Reduced vision
Ischemic Ulcer
- S/S: no pulse
- Night pain
- No hair
- Palor when elevated
- Lower extremity
Distal lateral foot and ankle
Puched out appearance
Ischemic Ulcer
- Prognosis: address reason for poor arterial circulation
- MI: observation, duplex scanner, CT, MRI
- Replace affected blood vessels or put in stents
- Hyperbaric oxygen
Ischemic Ulcer
- Physical Therapy
- Check dorsal pedal pulse
- Careful with treatments
- Avoid warm whirlpools
- Document wounds
Ischemic Ulcer
- Over 60
- Higher in females
- Impaired circulation
- injuries
- Varicose veins
- Thrombosis of deep veins
- Hrt disease
- DVT
- obesity
Venous Stasis Ulcer
- Location
Medial aspect lower leg above ankle
Irregular shape
Pulses intact
Necrotic tissue: yellow, white or gray
Exudate
Edema
Usually heal
Venous Stasis Ulcer
- Medical intervention
Debridement
- PT: wound eval and treatment
Venous Stasis Ulcer
- Aka bedsore
- Immobile patients
- Elderly
- Mentally impaired with low nutrition
- SCI
- CVA (stroke)
Pressure Ulcer
- Prolonged pressure over boney prominence
- What areas of body?
- Don’t move enough, compromise blood vessels, lose nutrition to tissue
- Compression > 2 hours
Pressure Ulcer
- S/S
Red initially
Area may open up
Muscle becomes damaged quickly
Can develop sinus tracts
*
Pressure Ulcer
Classification
I: red/purple skin, warm or cool
II : partial thickness: blister or small ulcer
III: full thickness skin loss with tissue necrosis
IV: full thickness with damage to muscle, tendon and bone
Pressure Ulcer
- Prognosis:
Good for early stage
Infection can interfere
- MI: treat like all wounds
Nutritional status
PREVENTION IS KEY
Pressure Ulcer
