VENOUS STASIS ULCERS

Venous stasis ulcer: occurs from chronic deep vein insufficiency and stasis of blood in the venous system of the legs An open, necrotic lesions that results when an inadequate supply of oxygen-rich blood and nutrients reaches the tissue The result is cell death, tissue sloughing, and skin impairrment

Decreased circulation to the area contributes to the development of infection and prolonged healing

CLINICAL MANIFESTATIONS Varying degrees of pain may be reported, ranging from mild discomfort to a dull, aching pain The skin is visibly ulcerated and has a dark pigmentation Edema may be present Ulcerations often occur around the medial aspect of the ankle Pedal pulses are present

ASSESSMENTS Pain Predisposing factors such as thrombophlebitis, venous insufficiency, and/or diabetes mellitus are noted Inspection of ulcerated areas: size, location, and condition of skin, color and temperature Palpate pedal pulses, and observe presence of edema

DIAGNOSTICS Venography and Doppler ultrasonography - Purpose of test utilize to confirm venous insufficiency and stasis

MEDICAL MANAGEMENT Focusing on promoting wound healing and preventing infecitions Intake of protein is essential becaue large amounts of protein in the form of albumin are lost through the ulcers Also Vit. A and C and the mineral zinc to promote tissue healing Debridement of necrotic tissue, antibiotic therapy, and protection of the ulcerated area are usual treatments

TYPES OF DEBRIDEMENT Mechanical- by applying wet-to-dry dressing to the wound, dressing is applied damp, when dry, it is removed, pulling off the debris that has adhered to the dressing Chemical- use of enzyme ointments such as Elase over the ulcer to break down necrotic tissue Surgical- using of scalpel is done when other measures are unsuccessful

Unna paste boots can be use to protect the ulcer and provides constant and even support to the area A moist, impregnated gauze is wrapped around the foot and leg It may be left on for 1-2 weeks

Nx INTERVENTIONS Perform dressing changes per physician order Assess signs and symptoms of infections Provide antibiotic therapy Encourage nutritional intake to promote healing Elevate extremities when sitting or lying to promote venous return and decrease the incidence of edema and venous stasis Assess level of discomfort

PATIENT TEACHING preventing infections Maintaining peripheral tissue circulation Avoiding venous stasis Proper wound care and dressing changes

PROGNOSIS Venous stasis ulcers are chronic condition caused by chronic insufficiency and delayed healing. Most venous ulcers heal with therapy.