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Wound Care and Inflammation

Terms in this set (173)

Arterial insufficiency ulcers (also known as Ischemic ulcers or Ischemic wounds) are mostly located on the lateral surface of the ankle or the distal digits. They are commonly caused by peripheral artery disease (PAD)

The ulcer has punched-out appearance. It is intensely painful. It has gray or yellow fibrotic base and undermining skin margins. Pulses are not palpable. Associated skin changes may be observed, such as thin shiny skin and absence of hair. They are most common on distal ends of limbs.

The management of arterial insufficiency ulcers depends on the severity of the underlying arterial insufficiency. The affected region can sometimes be revascularized via vascular bypass or angioplasty. If infection is present, appropriate antibiotics are prescribed. When proper blood flow is established, debridement is performed. If the wound is plantar (on walking surface of foot), patient is advised to give rest to foot to avoid enlargement of the ulcer. Proper glycemic control in diabetics is important. Smoking should be avoided to aid wound healing. Antibiotics, if an infection is present
Anti-platelet or anti-clotting medications to prevent a blood clot
Topical wound care therapies
Compression garments
Prosthetics or orthotics, available to restore or enhance normal lifestyle function

These ulcers are difficult to heal by basic wound care and require advanced therapy, such as hyperbaric oxygen therapy or bioengineered skin substitutes. Arterial Ulcer Treatment
Arterial ulcer treatments vary, depending on the severity of the arterial disease. Depending on the patient's condition, the physician may recommend invasive testing, endovascular therapy or bypass surgery to restore circulation to the affected leg.

The goals for arterial ulcer treatment include:

Providing adequate protection of the surface of the skin
Preventing new ulcers
Removing contact irritation to the existing ulcer
Monitoring signs and symptoms of infection that may involve the soft tissues or bone

On the feet - often on the heels, tips of toes, between the toes where the toes rub against one another or anywhere the bones may protrude and rub against bed sheets, socks or shoes. They also occur commonly in the nail bed if the toenail cuts into the skin or if the patient has had recent aggressive toe nail trimming or an ingrown toenail removed.

Causes: Poor circulation, often caused by arteriosclerosis
Other disorders of clotting and circulation that may or may not be related to atherosclerosis
Diabetes
Renal (kidney) failure
Hypertension (treated or untreated)
Lymphedema (a buildup of fluid that causes swelling in the legs or feet)
Inflammatory diseases including vasculitis, lupus, scleroderma or other rheumatological conditions
Other medical conditions such as high cholesterol, heart disease, high blood pressure, sickle cell anemia, bowel disorders
History of smoking (either current or past)
Pressure caused by lying in one position for too long
Genetics (ulcers may be hereditary)
A malignancy (tumor or cancerous mass)
Infections
Certain medications