Ulcerations
Superficial loss of surface tissue as a result of
death of the cells is called an ulceration. A simple ulcer, such as the kind
found in a small, superficial, partial-thickness burn, tends to heal by granu-lation
(ie, new tissue granules) if kept clean and protected from injury. If it is
exposed to the air, the serum that escapes will dry and form a scab, under
which the epithelial cells will grow and cover the surface completely. Certain
diseases cause characteris-tic ulcers; tuberculous ulcers and syphilitic ulcers
are examples.
Ulcers
related to problems with arterial circulation are seen in patients with
peripheral vascular disease, arteriosclerosis, Raynaud’s disease, and
frostbite. In these patients, treatment of the ulcers is concurrent with
treatment of the arterial disease. Nursing management includes the use of the
dressings discussed at the beginning. If nursing interventions are in-stituted
early in the progression of an ulcer, the condition can often be effectively
improved. Surgical amputation of an affected limb is a last resort.
Pressure ulcers involve breakdown of the skin due to prolonged pressure and insufficient blood supply, usually at bony promi-nences.
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