Vascular Wounds
Vascular wounds are chronic, or long term breaches in the skin caused by problems with the vascular system, also known as the circulatory system. Vascular wounds can be dangerous as they may not heal normally and can lead to an increased risk of infection. Often, those with vascular wounds have little or no sensation in the ulcer area. This means that you may not notice it until it has progressed to become large and/or infected. Vascular wounds are generally divided into two types: venous ulcers and arterial ulcers.
Venous Ulcers
Venous Ulcers are generally found below the knee, above the ankle and on the inner side of the leg. The wound will appear red in coloration and may include a yellow tissue. If the wound is infected there will be green or yellow discharge and significant drainage. The edges of the wound most often appear irregular or jagged in shape. The surrounding skin is usually swollen and discolored with a tight or shiny appearance.
Arterial Ulcers
Arterial ulcers are most often found on the heels, toes and between toes where friction occurs, though they can appear anywhere bones may protrude from the foot and rub against surfaces. It is also common to find them in the nail bed after a recent “aggressive” toenail trimming.
The wounds will appear black, yellow, or grey, normally they do not bleed. The edges of the wound most often appear “punched out” and the skin surrounding the area usually does not swell. Arterial ulcers primarily occur in people who suffer from poor circulation. They typically can be very painful.
Treatment Modalities
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Wound Debridement
Wound Debridement is an important part of wound healing. Debridement is the process of removing necrotic or dead tissue that occurs during wound healing. This tissue inhibits the body’s ability to recover and develop new tissue during the healing process, making debridement critical in preparing a wound for quick and efficient healing.
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Offloading
Offloading refers to removing pressure from the affected appendage. Offloading is achieved through a variety of methods. The best option for any patient will be decided by the clinician and patient together.
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Compression Therapy
Compression Therapy involves the use of specialized stockings to reduce swelling and increase blood flow in lower limbs. Compression stockings attempt to apply gentle pressure and strengthen vein support. The stockings slowly stretch out vein walls which in turn helps eliminate swelling.
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Infection Control
Infection control is a critical element of any wound treatment. It can only be effective if both patient and care providers are dedicated to the proper infection control practices. Proper clinical infection control practices require the existence of an official Infection Control Program.
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Restoring Blood Flow
Poor circulation is a primary contributor to complications with wound healing. Restoring blood flow to areas showing signs of reduced circulation is critical to proper wound care and to avoid amputation.
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Advanced Wound Dressings
When caring for wounds, clinicians have a wealth of options for bandages and dressings. These options are considered superior to the basic gauze and tape and are referred to as Advanced Wound Dressings. Advanced dressings reduce heal times and decrease risk of infection, thereby reducing drainage.
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Skin Substitutes
Skin substitutes have been used to aid in wound closure for centuries. They also help to control wound pain and replace the skin functions to promote proper wound healing. Skin substitutes come in two varieties, temporary and permanent.
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Negative Pressure Wound Therapy
Negative pressure wound therapy is an option for treating burns, various types of ulcers and other chronic wounds. NPWT uses a dressing that creates a seal over the wound and around tubing which is attached to a pump which will draw out fluid and infection from a wound to help it heal.