China
Africa
Explore chapters and articles related to this topic
Leg ulcers: diagnostic approach and management
Published in Robert A. Norman, Geriatric Dermatology, 2020
A. I. Rojas, Y. M. Bello, T.J. Phillips
The ulcer bed is characterized by the presence of granulation tissue or fibrinous material (Figure 3)15–16. Moderate to heavy exudate may be present. The surrounding skin may have red-brown hemosiderin pigmentation (Figure 4)15,16. Eczematous changes such as erythema, scaling, pruritus and weeping are common15. Periwound skin can be indurated, shiny, fibrotic and bound-down, a clinical sign called lipodermatosclerosis (Figure 3). Lipodermatosclerosis tends to occur around the ankles, but it may involve extensive areas of the leg, giving it the so-called ‘inverted champagne botde’ appearance (Figure 5)15. Attempts to pinch the tissue between the thumb and forefinger illustrate the thickened nature of this skin (Figure 3). Edema of the lower limbs and varicosities may frequently be present.
Ostomy, Fistula, and Skin Management
Published in John K. DiBaise, Carol Rees Parrish, Jon S. Thompson, Short Bowel Syndrome Practical Approach to Management, 2017
Christine T. Berke, Cathi Brown
Conventional wound management systems are not always effective in molding to abdominal contours or achieving adequate wear time. Skin protection remains a top priority. With a custom-made system, a protective layer is applied onto the periwound skin (e.g., sheets of hydrocolloid or adherent foam dressings). A soft pliable catheter is wrapped in slightly moistened gauze and laid in the wound bed (e.g., a 28-Fr red radiopaque catheter). The tubing is flexible and connects easily to low continuous suction. A transparent drape is placed over the entire dressing, and strip paste and/or moldable caulking rings/seals are used around the tubing to achieve/maintain a seal (Figure 22.12).
Pressure Ulcers in Older Adults
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
The goal of local wound care for pressure ulcers in the elderly is to create a warm, moist wound bed with healthy surrounding tissue to promote wound closure. Protecting the skin surrounding a wound needs constant evaluation. Erythema and heat may be indicative of infection. Erythema alone may result from an allergy to the dressing (contact dermatitis). Periwound protection with moisture barriers or skin sealants is essential to protect from excessive moisture from bowel or bladder incontinence.
Optimal hidradenitis suppurativa topical treatment and wound care management: a revised algorithm
Published in Journal of Dermatological Treatment, 2018
Afsaneh Alavi, R. Gary Sibbald, Robert S. Kirsner
Another concern is the absorbency of foam dressings. Superabsorbent dressings have higher fluid absorbency and a mechanism to ‘lock’ in the fluid that is absorbed. Foam dressings have a moderate absorbency but create a moisture balance that gives some of the moisture back to the surface of the wound often causing periwound maceration that favors bacterial growth. A superabsorbent polymer dressing is similar to diaper technology. These polymers absorb even more moisture than a foam, holding the moisture in their polymers with a fluid lock, and preventing the fluid from being given back to the surface of the skin like a foam dressing. Furthermore, cost of a superabsorbent dressing is much less than foam technology. The superabsorbent technology is especially useful to manage the high exudate associated with HS patients with tunnels or sinus tracts. Therefore, we suggest a revised algorithm which is presented in Figure 1. Future studies are required to further refine the algorithm and with more specified instructions for wounds associated with HS.