Alginate Dressings

Ulcers of the lower extremities of the legs, ankles and feet

An ulcer is a sore on the skin or mucous membrane, often associated disintegration and training pus. Ulcers can cause total loss title = "Skin" epidermis> title = "" dermis dermis> and in more advanced cases title = "bacon" Subcutaneous fat>. Ulcers that occur in the skin are characterized by inflamed tissue with an area of red skin. The sores are often associated with diabetes, but many other causes, including exposure to heat or cold, irritability and problems circulation.

ulcers and lower limb amputations are a growing problem among diabetics. Data from 1983 to 1990 National Hospital Discharge Survey (NHDS) indicate that 6% of admissions list diabetes in the output folder are also provided lower extremity ulcer. At the hospital listed as diabetes, Chronic ulcers occurred in 2.7% of patients. The average length of stay for discharges of ulcer conditions of diabetes was 59% higher longer than for discharges of diabetes without ulcers. Recent data suggest that foot ulcers precede approximately 85% of nontraumatic amputations members lower (LEA) in people with diabetes.

More than half of lower limb amputations in the United States occur in people with diagnosed diabetes. NHDS data also indicate that there were about 54,000 people with diabetes who underwent the non-traumatic LEAs in 1990. lower limb amputations are common in people with diabetes than without diabetes.

Several studies have shown the beneficial effect of patient education in reducing the LEA. One trial showed that patients randomized Self-Care has been helpful in preventing serious foot injuries. Amputation Prevention Several programs reported elimination differences pre and post-intervention in the amputation frequency after instituting a comprehensive and multidisciplinary care programs of the feet. Part of hospital and care program itself should be an administrator of a current freeze on growth factors to the wound.

What are the types and symptoms of ulcers? Ulcers may or may not be painful. The patient is usually a swollen leg and may feel burning or itching. There may also be a rash, redness, skin discoloration, brown or dry and flaky. The three most common types of leg and foot ulcers are:

1. Venous stasis ulcers
2. Arterial (ischemic ulcers)
3. Neurotrophic (diabetic ulcers)

Ulcers are generally defined by the appearance of the ulcer, the ulcer location and how the limits and the skin around the ulcer seen as defined below:

1. venous ulcers

Venous ulcers are located below the knee and are primarily inner leg, just above the ankle. The base of a venous ulcer is usually red and may be covered with yellow fibrous material, or may have a discharge greenish or yellowish if the ulcer is infected. fluid drainage may be important with this type of ulcer.

The edges of the venous ulcer are usually irregularly shaped and surrounding skin is often discolored and swollen. It may even be warm or hot. With edema (swelling) of the skin may appear shiny and tight. The skin of the leg also may have a brown or purple-called "changes in the skin of stasis.

Venous ulcers are common among patients with a history of leg swelling, varicose veins, leg veins or a history of blood clots in the veins either superficial or deep in the legs. Ulcers can affect one or both legs.

Venous ulcers affect 500,000 to 600,000 people in the United States each year and account for 80-90% of all ulcers leg.

2. Of blood (ischemia)

Arterial ulcers are usually on the feet and often occur in the heels, the tips of feet, toes, between toes, where they rub against each other and the bone can protrude and rub against bed sheets, socks or shoes. Arterial Ulcers also occur frequently in the bed of the nail if the nail cuts into the skin or if the patient has recently had an aggressive trimming or an ingrown toenail eliminated.

The basis of an artery or ischemic ulcer is usually not bleed. It is a yellow, brown, gray or black. The borders and surrounding skin generally appear as if they were pierced. If irritation or infection are present, may or may not have swelling and redness around the base of the ulcer. It can also be a redness around the foot when the leg is hanging down, the redness often turns a pale white / yellow when leg is elevated.

Arterial ulcers are usually very painful, especially at night. The patient may instinctively feet hung on the side of the bed Relieve Pain. Patients often have prior knowledge of the poor circulation in the legs and may have a disability support.

3. Neurotrophic (Diabetes)

Neurotrophic ulcers are usually located at points of increased pressure on the soles of the feet. However, neurotrophic ulcers trauma can occur in any part of the foot. Such ulcers occur mainly in people with diabetes, but someone who affected the sensation of the feet can be affected.

The base of the ulcer is variable, depending on the circulation and may appear pink / red or brown / black. The edges of the ulcer are cut and surrounding skin are generally quiet.

Neuropathy and peripheral arterial disease are often comorbid disorders in people with diabetes. The nerve damage (neuropathy), resulting in the feet is often a loss of sensation in the feet and changes in the production of sweat glands. Thus, a person can not feel the development of the horn of the foot or cracks, which increases the risk of injury or infection. Symptoms of neuropathy include tingling, numbness, burning or pain y.

What causes leg ulcers? leg ulcers can be caused by:

1. Poor circulation, often caused by arteriosclerosis
2. Diabetes
3. Venous insufficiency (lack of valves in the veins of the legs caused by congestion and slowing blood flow in veins)
4. Other bleeding disorders and traffic that may or may not be related to atherosclerosis
5. Renal (kidney)
6. Hypertension (treated or untreated)
7. Lymphedema (accumulation of fluid that causes swelling of the legs or feet)
8. Inflammatory diseases such as vasculitis, lupus, scleroderma or other neurological conditions
9. Other medical conditions such as cholesterol high, heart disease, hypertension, sickle cell anemia, the intestinal
10. History of smoking (current or past)
11. Pressure caused by lying in one position for too long
12. Genetics (can be inherited)
13. A malignant tumor (cancerous tumor o)
14. Infections
15. Some drugs

How are leg ulcers diagnosed and treated?

First Instead, the patient's medical history is evaluated. A specialist will carefully examine the wound and the wound can perform tests such as X-rays, MRI, CT and vascular studies invasive to help develop a treatment plan. The goals of treatment are to relieve pain, accelerate healing and wound healing. treatment plan for each patient should be individualized based on patient health, health status, and ability to care for wounded.

Treatment options in all the ulcers include:

1. Antibiotics, if infection is present
2. Platelet-platelet drugs or anti-coagulation to prevent a blood clot
3. Topical Wound Care therapies (including topical growth factors)
4. Compression garments
5. Prosthetics and Orthotics, available to restore or improve the function of normal lifestyle

Venous ulcers are treated differently with compression of the leg to reduce edema or swelling. Treatment may include using compression stockings, multilayer compression wraps, or wrapping a bandage or dressing on the fingers and walking in the area below the knee. The compression type of treatment required is determined by the physician according to the characteristics the base of the ulcer and the amount of drainage from the ulcer.

The type of dressing prescribed for ulcers is determined by the type of ulcer and the appearance at the base of the ulcer. The following types of dressings:

1. Moist to wet dressings
2. Hydrogel / hydrocolloid
3. Alginate Dressings
4. Collagen dressings
5. Debridement Agents
6. Antimicrobial dressings
7. Composite dressings
8. synthetic skin substitutes
9. ointment growth factor

Treatment of ulcers pressure varies depending on the severity of artery disease. Noninvasive vascular tests to physicians the diagnostic tools to assess the potential for scarring of the wound. Depending on the patient's condition, your doctor may recommend invasive testing surgery, endovascular treatment or bypass surgery to restore circulation to the affected leg. Goals of treatment arterial ulcers include:

1. Provide adequate protection of the skin surface
2. Prevention of ulcers news
3. Withdrawal of the irritation of contact for existing ulcer
4. Follow signs and symptoms of infection may involve soft tissue or bone.

Neurotrophic ulcers are treated are treated to avoid pressure and body weight in the affected leg until the ulcer began to heal. Regular debridement (removal of infected tissue) is usually necessary before a neurotrophic ulcer can heal. Often, special shoes or braces must be worn.

Wound Care at home

As indicated in the preceding paragraph, a wound care program, including a welcome wound care by the patient is essential to the healing process. Patients should receive clear instructions to care for their wounds at home. These instructions include:

1. Keep the wound clean
2. Change the dressing as directed
3. Medications as prescribed
4. Topical application of growth factors as indicated
5. Drink plenty of fluids
6. Following a healthy diet, as recommended, including plenty of fruits and vegetables
7. Exercise regularly, as directed by a physician
8. The use of proper footwear
9. The use of bandages, where appropriate, as indicated

The treatment of all ulcers of skin care begins with the hand and foot care. The inspection of the feet and the skin by the patient is very important, especially for people with diabetes. Detection and treatment of fever and skin lesions early may help prevent infection and prevent ulcer worse. Here are some guidelines:

1. Gently wash the affected area in the leg and feet daily with mild soap and warm water. Washing helps loosen and remove dead skin and other debris or drainage from the ulcer. Delicate and dry your skin and feet, including between the toes. Do not rub the skin or the area between the toes.
2. Each day, check legs and as the ups and downs of the feet and areas between the toes. Look for blisters, cuts, cracks, scratches or other wounds. Also check for redness, increased toenails heat, red, corns and calluses. Use a mirror to see the leg or foot if necessary, take a look or a member of the family in the area you.
3. Once or twice a day apply a lanolin cream base for the legs and soles and the tops of your feet to prevent dry skin and cracks. No put lotion between toes or in areas where there is an open wound or cut. If the skin is very dry, use moisturizer frequently.
4. Care and toenails regularly. Cut your toenails after bathing, when they are soft. Cut nails straight and smooth with an emery cardboard.
5. No self-treat corns, calluses or other foot problems. Go to a podiatrist to treat these conditions.
6. Do not wait to treat a fever mild skin problem. Follow the instructions for your Physcia is.
7. Ask your doctor about using an ointment growth factor in wound area open.

How can ulcers be prevented? controlling risk factors can help prevent ulcers countries developing or worsening. Here are some ways to reduce their risk factors:

1. Stop smoking
2. Control your blood pressure
3. Control your cholesterol and triglycerides through dietary changes and taking prescribed medications
4. Limit your intake of sodium (salt)
5. Manage their diabetes and other health problems if
6. Exercise – start a walking program after speaking with his Physcia
7. Lose weight if overweight
8. Ask your doctor about aspirin to prevent blood clots

About the Author

Drs. Al-Qahtani and Maguire are Co-Founders of A & G Skin Solutions, Inc. of Irvine, California, USA www.agskinsolutions.com Both Al-Qahtani and Maguire are NIH-supported research scientists, professors at medical schools, with numerous peer-reviewed publications. Maguire was awarded the NIH’s prestigious Fogarty Fellowship for his work in studying the nervous system, and Al-Qahtani has received numerous international awards for his work in immunology and medicine. Both professors have been working on stem cells dating back to 1997. Dr. Maguire is currently President of the San Diego Neuroscience Group at the Scripps Research Institute (http://www.scripps.edu/services/sdneuro/ )

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