VENOUS STASIS ULCERS Venous stasis ulcer occurs from
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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.
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