Wound Management Flashcards
Lipodermatosclerosis
Inverted Champagne Bottle Legs
70% of Chronic Wound is caused by?
Chronic Venous Insufficiency
Signs of Chronic Venous Insufficiency
- Pitting Oedema
- Haemosiderin Staining
- Venous ulcer - painless, irregular, copious exudate
- Atrophie Blanche
- Lipodermatosclerosis
RF of Chronic Venous Insufficiency
Obesity, DVT, Poor mobility
Tx of Chronic Venous Insufficiency
- Graduated compression - toe to knee (ankle 30mmHg)
- Address factors that delay healing
- Must exclude arterial involvement
4 Principles of Wound management
- Define Aetiology - Vascular/Mechanical/Neuropathic/Infective
- Control wound healing factors
- Select appropriate dressing
- Plan for management
Signs of lymphoedema
- Scale and keratin build-up
- Skin thickening
- Hard to pick up skin
- Non-pitting oedema
Secondary causes of Lymphoedema?
- Cancer
2. Infection - Filariasis (Elephantiasis)
4 Si/Sx of Peripheral Arterial Disease (PAD)
- Claudication to rest pain
- Lower ABI - nml is 1.0
- Weak pulse, poor refill
- Arterial ulcer - regular, punched out, below ankles
Tx of Arterial ulcers
- Improve flow - angioplasty/stent/bypass (essentially angina of leg)
- Amputation of digit or limb
Difference between Ischaemic or neuropathic ulcers?
Neuropathic is:1. Painless
- Bony prominence/area of pressure
- Good circulation for healingWhich are all opposite in ischaemic
RF and Mx for Pressure ulcer
- Neuropathy
- Immobility
- Malnutrition
Mx: manage RF, risk assessment, Foam
Friction vs Shear
Friction - epidermis worn away by rubbing external surfaceShear - skin is restrained from sliding while tissue are forced to move
4 Stages of Pressure Ulcer
- Erythema remains after light pressure
- Skin loss involving epidermis/dermis
- Skin loss involving subcutaneous tissue/fascia
- Skin loss with necrosis to underlying structures (muscle/bone/joint etc)
Complication of leg ulcers
- Infection
- Gangrene
- Calcification
- Neoplastic development