Venous stasis ulcers

Shifts in the cutaneous microbiome have also been noted in chronic ulcer disease, such as those caused by venous stasis or diabetes (175). Patients with chronic ulcers treated with antibiotics have been shown to have an increased abundance of Pseudomonadaceae while an increase in Streptococcaceae has been noted in diabetic ulcers (175). A longitudinal shift in wound microbiota has also been shown to coincide with impaired healing in diabetic mice, and may interact with aberrantly expressed host cutaneous defense response genes leading to ulcerogenesis (176). When compared to controls, the feet of diabetic men has also been noted to have decreased populations of Staphylococcus species, a relative increase in the population of S. aureus and increased bacterial diversity, which may increase the risk for wound infections in diabetic patients (177). 

Ethacridine (6,9-diamino-2-ethoxyacridine) is widely used in the local treatment of inflammatory or ulcerative conditions of the skin, particularly crural eczema due to venous stasis. Many publications point to the high frequency of exacerbation involving local allergic reactions and also generalized eczematous reactions (SEDA-11, 474). 

The client diagnosed with chronic venous insufficiency has a venous stasis ulcer that is being treated with autolytic medication for debridement and an occlusive dressing. The nurse notices a foul-smelling odor. Which action should the nurse take ... 

Obtain a culture and sensitivity of the venous stasis ulcer. 

The wound care nurse is applying an enzyme debridement ointment to a client with a venous stasis ulcer on the left ankle. Which priority intervention should the nurse implement ... 

The client with a venous stasis ulcer has exudate. A calcium alginate dressing is applied to the draining ulcer. The client asks the nurse, How often will the dressing he changed Which statement is the nurse s hest response ... 

The client with a venous stasis ulcer is being treated with the debriding agent dextra-nomer (Debrisan), highly porous special beads. The nurse notes the beads are a grayish-yellow color. Which action should the primary nurse implement ... 

Venous insufficiency is the most common cause of leg ulcers. Venous insufficiency is often caused by deep thrombosis or weakness of the valve system of the lower leg superficial veins, but the wound may also be caused due to, for example, arterial circulatory disorders, vasculitis or diabetes. The first sign of venous insufficiency is lower leg swelling but also eczema around the ankle, caused by venous stasis, can be an early marker (Mayrovitz and Larsen, 1997). The most important treatment is to counteract the oedema condition, which can be done by keeping the leg in a raised position or by applying a compression bandage to the leg (Reichenberg and Davis, 2005 Rajendran et al., 2007). 

Bishop JB, Phillips LG, Mustoe TA. A prospective randomized evaluator-bUnded trial of two potential wound healing agents for the treatment of venous stasis ulcers. J Vase Surg August 1992 16 251-7. 

OrCel Forticell Bioscience Inc. (US) Bilayer scaffold made of a type I bovine collagen porous sponge cultured with human fibroblasts and a nonporous collagen side cultured with human keratinocytes Diabetic and venous stasis ulcers Marketed... 

Indicated for wounds with moderate to heavy exudate, such as pressure ulcers, infected wounds, diabetic ulcers and venous stasis ulcers Sorbsan Maersk Alginic acid... 

Jung, S.B., Day, D.E., Day, T., Stoecker, W., and Taylor, P. (2011) Treatment of non-healing diabetic venous stasis ulcers with bioactive glass nanofibers. Wound Repair Regen., 19, A30 A40. 

Post-phlebrtic syndrome, a complication of acute DVT is estimated to occur in approximately 4% of the population (213). This syndrome is characterized by persistent pain, edema, hyperpigmentation, induration of the skin, and stasis ulceration (214). The post-phlebrtic syndrome may be due to venous hypertension as a result of outflow obstruction or damage to the valves and in the cutaneous microcirculation may manifest as tissue hypoxia and lymphatic obstruction. Chronic venous insufficiency may lead to post-phlebetic syndrome. The syndrome may be the result of abnormalities in the superficial, the perforator, or the deep venous system. The diagnosis is purely clinical. The pharmacologic treament of post-phlebetic syndrome is rather limited, with pentoxifylline reported to improve the healing rate of skin ulcers. 

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