| Section: |
Complex Wounds |
| Procedure Title: |
Venous Stasis Ulcers |
| Description: |
Venous ulcers are located below the knee and are primarily found on the inner part of the leg, just above the ankle.
The base of a venous ulcer is usually red. It may also be covered with yellow fibrous tissue or there may be a green or yellow discharge if the ulcer is infected. Fluid drainage can be significant with this type of ulcer.
The borders of a venous ulcer are usually irregularly shaped and the surrounding skin is often discolored and swollen. It may even feel warm or hot. The skin may appear shiny and tight, depending on the amount of edema (swelling). The skin may also have brown or purple discoloration about the lower leg, known as "stasis skin changes."
Venous stasis ulcers are common in patients who have a history of leg swelling, long standing varicose veins, or a history of blood clots in either the superficial or the deep veins of the legs. Ulcers may affect one or both legs.
Venous ulcers affect 500,000 to 600,000 people in the United States every year and account for 80 to 90% of all leg ulcers.
Treatment options for all ulcers may include:
* 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
Venous ulcers are treated with compression of the leg to minimize edema or swelling. Compression treatments include wearing compression stockings, multilayer compression wraps, or wrapping an ACE bandage or dressing from the toes or foot to the area below the knee. The type of compression treatment prescribed is determined by the physician based on the characteristics of the ulcer base and amount of drainage from the ulcer.
The type of dressing prescribed for ulcers is determined by the type of ulcer and the appearance at the base of the ulcer. Types of dressings include:
1. Moist to moist dressings
2. Hydrogels/hydrocolloids
3. Alginate dressings
4. Collagen wound dressings
5. Debriding agents
6. Antimicrobial dressings
7. Composite dressings
8. Synthetic skin substitutes
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