Chronic leg ulcers can be divided into three types; venous, arterial and mixed aetiology.
Venous leg ulcers
Venous leg ulcers occur due to long-term increased pressure in the venous system. It is a consequence of impaired valve function, venous obstruction or failure of the calf muscle pump function in the leg. Wounds often return because the of the chronic nature of the condition.
Patients with venous leg ulcers often have a history of varicose veins, DVT, trauma, surgery of the lower limb, aching and swollen legs. The wound is often located over the medial malleaolus, the lateral malleolus, and the gaiter area of the leg.
Venous ulcers are shallow, have diffuse edges and are variable in size. The wound bed may be covered by yellow fibrin or red granulation. There is production of wound exudate which can be of a moderate to an excessive amount. Black necrosis might be present, and there can be an offensive odour. The skin around the wound is pigmented. The limb may be oedematous with signs of atrophe.
The best treatment for venous leg ulcers is a moist wound environment and compression. Assessment of the wound provides the basis for an individual wound care plan. It is important to dress a moist wound with a dressing that can manage the amount of exudates from the wound. A barrier film should be applied around the wound edges to prevent maceration from the exudates.
An assessment of the ankle brachial index (ABI) is always necessary before compression therapy is commenced.
0 of 1 questions completed
Task 8.3 Arterial ulcers
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Time has elapsed
You are going to help a patient with arterial problems. A Dopler and ankle/brachial index has been carried out, and the values are very low. The patient has a dry, black necrotic plaque on the heel. What kind of treatment would you initiate to eliminate necrosis?Correct
Correct! Arterial insufficiency can produce both wet and dry necrosis. In this case, you must debride the necrotic edge of the plaque and apply a bandage. The plaque will come off gradually, producing a ‘self amputation’ response. When the plaque falls off, the wound will be healed almost completely.
If you choose to treat necrosis with a wet process, the patient may get an infection in his foot quickly. It is difficult for the other professionals who review the wound to then decide if it is wet or dry necrosis when it is in gel state. Consider this before starting treatment of necrotic plaque.Incorrect
If you choose to treat necrosis with a wet process, the patient may get an infection in their foot quickly. It is then difficult for the other professionals who review the wound to decide if it is a wet or dry necrosis when it is in gel state. Consider this before starting treatment of necrotic plaque.
Arterial insufficiency can produce both dry and wet necrosis. If the wound is wet necrosis, it must be treated wet; if it is dry, it must be treated with a dry process. In this case, you must debride the necrotic edge of the plaque and apply a bandage. The plaque will come off gradually, producing a ‘self amputation’ response. When the plaque falls off, the wound will be healed almost completely.