What are they?
An ulceration is a defect or absence in the normal layers of the skin (epidermis and dermis), essentially creating a hole or cavity that may be wet or dry and can be difficult to heal. People with diabetes, poor circulation, or those who are bedridden are more prone to developing ulcerations. The severity, appearance, and response to treatment depend on the type and location of the ulceration and the overall health of the patient.
What causes them?
Ulcers can result from various factors, including loss of skin sensation, reduced blood flow, localized pressure, and issues with vein valves.
Diabetic ulcerations occur due to nerve damage, leading to reduced sensation. This means a diabetic patient might not feel a foreign object, like a needle, causing the skin to break down and form an ulcer.
Ischemic ulcerations are caused by reduced blood flow to the feet from calcified arteries or blocked blood vessels, making them extremely painful. Without proper blood supply, the skin deteriorates and ulcers develop.
Pressure ulcerations result from prolonged contact with surfaces like a bed mattress, commonly affecting bedridden patients. The sustained pressure cuts off blood supply, leading to tissue death and ulceration.
Venous stasis ulcerations are caused by faulty valves between the superficial and deep veins, leading to fluid buildup in the legs. The excess fluid seeps into the skin, eventually causing ulcers.
How do you treat them?
for ulcers varies based on the type. Generally, treatment involves debridement to remove dead or nonviable tissue, which helps relieve pressure. Non-weight bearing may be recommended to reduce stress on the ulcer. Topical wound gels and creams keep the ulcers clean and hydrated, and some gels assist in removing dead tissue. Ischemic ulcers may require procedures to restore blood flow, while venous stasis ulcers are often treated with compression dressings to manage fluid buildup. Effective ulcer treatment usually demands time, patience, and patient cooperation.
