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Pressure on anterior tibialis
tendon from compression wrap
applied incorrectly
Purple or very dark areas that are surrounded by
profound redness, edema, or induration suggest that
deep tissue damage has already occurred and
additional deep tissue loss may occur.
The deepest level of tissue must be
visible in order to stage a pressure
wound.
Offload
Nutrition
Dress
Debride
Protect
Grade 3
Deep Ulcer
With
Abscess/Osteo
Charcot
Hammer Toe
Callus Formation
Blood sugar
control
Debride
Off
Loading
Manage
Bacteria
Dress
Re-
Vascularize
HBOT
(if criteria
met)
Eliminate Cause
Pain Control
Debridement
Moist Wound Care
HBOT
• Vasodilators & Decrease Plaque
Formation
ACE Inhibitors—(Lisinopril,
Captopril, etc) end in “il”
• Relaxes smooth muscle & vasodilates
Pletal (Cilostazol)
Eliminate
Cause
sutures
mesh
infection
Heal
Debride
Moist
Wound
Care
Specialist
Injury
Hemostasis
Inflammation
Proliferation
Maturation
Pros: Come in all shapes, sizes, and thicknesses
Cons: Must be applied correctly or will roll—choose
appropriate size, thickness for location of wound
Pros: Hydrogel pads are great
for burns, can be very soothing
Hydrogels come in all forms
Cons: Can be difficult to find
and can be costly depending on
brand
Highly absorptive fiber layers such as cellulose, cotton or
rayon
Pros: Non-adherent, easy to use, absorbent
Cons: May be costly
Pros: Lots to choose from, provides moist
environment, effective with
hypergranulation
Cons: Can be expensive if exudate
requires daily changes
Damaged
tissue
Cytokines
Excess
proteases
Stasis Dermatitis
Arterial
Stage 1 pressure
This is usually 2 to 2.4 absolute
atmospheres (the equivalent of the
pressure exerted by a 33-45 foot dive
into sea water)
Radionecrosis from treatment for
Cancer of Laranyx 05/02/02
Same neck, 07/09/02
after 40 hyperbaric
treatments
Tissue
Hypoperfusion
Hypoxia Infection
Left Lower Extremity Ulcer, before and after 40 treatments
The Basics of Identifying and Caring for Problem Wounds
The Basics of Identifying and Caring for Problem Wounds
The Basics of Identifying and Caring for Problem Wounds
The Basics of Identifying and Caring for Problem Wounds
The Basics of Identifying and Caring for Problem Wounds

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The Basics of Identifying and Caring for Problem Wounds