Skin ulcer <ul><li>Skin ulcers are open sores that are often accompanied by the sloughing-off of inflamed tissue. </li></ul><ul><li>Alternative Names </li></ul><ul><li>Bedsore </li></ul><ul><li>Decubitus ulcer </li></ul>
Causes of skin ulcers <ul><li>Skin ulcers can be caused by a variety of events, such as trauma, exposure to heat or cold, problems with blood circulation, or irritation from exposure to corrosive material. Pressure ulcers, also known as decubitus ulcers or bedsores, are skin ulcers that develop on areas of the body where the blood supply has been reduced because of prolonged pressure </li></ul>
Causes of skin ulcers <ul><li>These may occur in people confined to bed or a chair, or in those who must wear a hard brace or plaster cast. Skin ulcers may become infected, with serious health consequences. </li></ul><ul><li>Diabetics face a serious problem with skin ulceration, especially of the feet. They can often injure their feet and not feel the injury. With no pain response and the poor healing ability of the diabetic such minor wounds can quickly turn ulcerous and often gangrenous, leading to amputation. </li></ul><ul><li>Bacterial or Viral Infections </li></ul><ul><li>Fungal infections </li></ul><ul><li>Other health conditions that can cause skin ulcers include mouth ulcers ( canker sores ), chronic venous insufficiency , diabetes , infection , and peripheral vascular disease . </li></ul>
Classification <ul><li>Doctors describe skin ulcers as appearing in various stages: </li></ul><ul><li>Stage 1 – The skin is red with soft underlying tissue </li></ul><ul><li>Stage 2 – increased redness, swelling, may be some blisters and loss of outer skin layers </li></ul><ul><li>Stage 3 – Skin has become necrotic down through the deep layers of skin, exposure of fat beneath the skin may be apparent in this stage </li></ul><ul><li>Stage 4 – Deeper necrosis, fat is definitely exposed, there may be muscle exposure </li></ul><ul><li>Stage 5 - Deeper loss of fat and necrosis of muscle </li></ul><ul><li>Stage 6 – very severe ulceration down to the bone level, destruction of bone may have begun, and sepsis of joints may be apparent </li></ul>
First aid <ul><li>Any new or changing pressure sore should be discussed with your doctor or nurse. Once a pressure ulcer is identified, steps must be taken immediately: </li></ul><ul><li>Relieve the pressure on that area. Use pillows, special foam cushions, and sheepskin to reduce the pressure. </li></ul><ul><li>Treat the sore based on the stage of the ulcer. Your health care provider will give you specific treatment and care instructions. </li></ul><ul><li>Avoid further trauma or friction. Powder the sheets lightly to decrease friction in bed. (There are many items made specifically for this purpose -- check a medical supplies store.) </li></ul>
First aid <ul><li>Improve nutrition and other underlying problems that may affect the healing process. </li></ul><ul><li>If the pressure ulcer is at Stage II or worse, your health care provider will give you specific instructions on how to clean and care for open ulcers. It is very important to do this properly to prevent infection. </li></ul><ul><li>Keep the area clean and free of dead tissue. Your health care provider will give you specific care directions. Generally, pressure ulcers are rinsed with a salt-water rinse to remove loose, dead tissue. The sore should be covered with special gauze dressing made for pressure ulcers. </li></ul><ul><li>New medicines that promote skin healing are now available and may be prescribed by your doctor. </li></ul>
Do not <ul><li>Do NOT massage the area of the ulcer. Massage can damage tissue under the skin. </li></ul><ul><li>Donut-shaped or ring-shaped cushions are NOT recommended. They interfere with blood flow to that area and cause complications. </li></ul>
Symptoms <ul><li>People with a skin ulcer may have an area of reddened skin. In advanced cases, people may have areas where the skin is open and oozing fluid. </li></ul>
Prevention <ul><li>If bedridden or immobile due to diabetes, circulation problems, incontinence, or mental disabilities, you should be checked for pressure sores every day. You, or your caregiver, need to check your body from head to toe. Pay special attention to the areas where pressure ulcers often form. Look for reddened areas that, when pressed, do not turn white. Also look for blisters, sores, or craters. In addition, take the following steps: </li></ul><ul><li>Change position at least every two hours to relieve pressure. </li></ul><ul><li>Use items that can help reduce pressure -- pillows, sheepskin, foam padding, and powders from medical supply stores. </li></ul>
Prevention <ul><li>Eat healthy, well-balanced meals that contain enough calories to keep you healthy. </li></ul><ul><li>Drink plenty of water (8 to 10 cups) every day. </li></ul><ul><li>Exercise daily, including range-of-motion exercises for immobile patients. </li></ul><ul><li>Keep skin clean and dry. </li></ul><ul><li>After urinating or having a bowel movement, clean the area and dry it well. A doctor can recommend creams to help protect the skin. </li></ul>
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