LIVING WITH CHRONIC WOUND

Chronic wounds are a frequently encountered problem in elderly and bedfast patients. Characteristics of chronic wounds include a loss of skin or underlying tissue that does not heal well with standard types of treatment. There are many different types of chronic wounds and we will discuss four of the most common types of skin ulceration: diabetic foot wounds, pressure ulcers, venous leg ulcers and arterial ulcers.

Diabetes and its effect on the skin

Diabetes affects almost every system within the body. Commonly over time, the protective functions of the skin become impaired. Careful inspection of the diabetic foot on a daily basis is one of the easiest, least expensive and most effective measures for preventing foot complications. Look for cuts, scrapes, or blisters; look at all parts of your feet, even between the toes. Diabetic foot ulcers commonly occur on the bottom or sides of the foot. A diabetic foot ulcer is one of the major complications of diabetes but can be treated effectively if addressed without delay.

What are the risks associated with a Diabetic Foot Ulcer?
If left untreated, a diabetic foot ulcer can quickly become infected. Diabetic foot ulcer infection is the most frequent reason for hospitalization in patients with diabetes. Unfortunately, an amputation can result from long-standing wound infections. Luckily, treating the diabetic foot wound with advanced treatments can prevent the majority of complications. Early detection and treatment of a diabetic foot ulcer can prevent up to 85% of amputations.

Pressure ulcers

A pressure ulcer is an area of skin and tissue that becomes damaged when a person is confined to a bed or chair. Prolonged pressure against the skin leads to decreased blood supply to the tissue. As a result, the tissue dies from lack of oxygen. Pressure ulcers are also called bed sores or decubitus ulcers and can range in difficulty from an area that is reddened to a large crater with exposed bone. The most common places for a pressure ulcer to develop are over the buttocks (sacrum), hips, heels and elbows. Treatment of a pressure ulcer requires a thorough assessment. Treatments must be individualized to facilitate the best healing potential.

What contributes to the development of a Pressure Ulcer?
Many factors increase the risk for developing a pressure ulcer. These include increased age as the elderly are at higher risk, poor nutrition, being immobile or in a wheelchair, having a chronic condition such as diabetes or arterial disease, suffering from urinary or bowel incontinence, or having a condition such as Alzheimer's disease.

Venous Leg Ulcers

Venous leg ulcers are the most common type of leg wound. They usually result from damage to your leg veins. Normally, veins drain the blood from the feet and lower leg back to the heart. Damage to leg veins affects the return of blood and leads to swelling and tenderness. The skin may feel dry and itchy. Over time brown or black staining can develop. Venous ulcers can occur in this type of leg. Venous leg ulcers have a tendency to recur in elderly patients.

What can be done to prevent a venous leg ulcer?

Walk or exercise regularly- this helps the calf muscle pump the blood back to your heart

Avoid sitting with your legs crossed

Sit with your legs raised whenever possible

Support stockings may be helpful- consult with your healthcare professional first

Inspect your feet and legs daily- report any changes in color or wounds

Treatment of a venous leg ulcer largely depends on the control of leg swelling and the prevention of infection. Special dressings are used which control drainage and reduce the opportunity of infection. Also, elastic stockings or wraps (compression) are widely used to treat and prevent the return of leg ulcers. Luckily, through proper management of the swelling the likelihood of the ulcer reoccurring can be reduced.

Arterial Leg Ulcers

Arterial ulcers are a result of complete or partial blockage of the arteries leading to cell death and skin ulceration.

Signs of arterial disease:

Cramping or pain in your calf while walking

Lack of pulse on the leg

Painful breaks in the skin

Cool or Cold skin

Delayed capillary return time (briefly push on the end of the toe and release, normal color should return to the toe in 5 seconds or less)

Shiny, thin or very dry appearing skin

Loss of foot hair

Treatment of an arterial ulcer has many purposes. The primary goal is to increase the circulation to the area in question. This can be done surgically or with medications, depending on the cause of the ulcer and the patient's overall medical condition. It also will depend on whether the large or small arteries of your leg have been affected. Choosing the appropriate product is vital to prevent infection, treat the underlying condition and preserve your extremity.

Wound Healing Solutions, LLC
600 Clements-Bridge Road
Barrington, NJ 08007
(856) 547-8000

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