Wounds
3 types:
* Neuroischemic
* Ischaemic
* Neuropathic
ISCHAEMIC ULCER
Critical Limb Ischemia - Peripheral Arterial Disease (PAD)
Thrombus= clot.
Embolism= break off from the thrombus
Signs, symptoms, presentation, referrals, imaging, dressings? Management?
Definition (PAD)= narrowing or occlusion by atherosclerotic plaques of arteries outside of the heart and brain.
Risk factors for PAD= high cholesterol, diabetes, smoking, hypertension, inactivity, and overweight/obesity.
Symptoms of PAD= intermittent claudication (calf muscle cramp, grading= fotain stages= rest pain
Causes:
* Blood flow blockage- deprives tissue from vital nutrients.
* Causing cellular damage and death.
* Damaged tissue deprived of adequate blood flow has decreased ability to heal.
* A primary cause of blocked blood flow is atherosclerosis – a condition in which artery walls thicken and become less flexible.
* Atherosclerosis common cause of ischemic wounds. Other conditions e.g. inflammation or excessive fluid build up also cause wounds.
* Arterial insufficiency often have other medical conditions that contribute to decreased sensation, particularly in the lower limbs.
* The inability to feel painful sensations and tissue’s lack of blood flow contribute to ischemic wound formation and impair ischemic wound healing.
Read more: http://www.woundcarecenters.org/wound-types/ischemic-wounds.html#ixzz2TrpFRbtg
Diagnostic imaging= angiography
Medication= warfarin- anticoagulant, aspirin antiplatelet.
DON’T DEBRIDE ISCHAEMIC WOUND EVERR!
Ischaemic wounds caused by arterial insufficiency
Slough tends to be firmly attached to the base of the wound
Dressings: ?
Different types of dressings:
* Atrauman ag- silver impregnated
* Ellevyn –
Goals for treatment of an ischemic wound:
* Relieve pain
* Prevention of more ischemic wounds
* Remove any irritants to the current wound
* Protect the skin...