Chronic Wounds: Evaluation and Management.
Publication/Presentation Date
2-1-2020
Abstract
Chronic wounds are those that do not progress through a normal, orderly, and timely sequence of repair. They are common and are often incorrectly treated. The morbidity and associated costs of chronic wounds highlight the need to implement wound prevention and treatment guidelines. Common lower extremity wounds include arterial, diabetic, pressure, and venous ulcers. Physical examination alone can often guide the diagnosis. All patients with a nonhealing lower extremity ulcer should have a vascular assessment, including documentation of wound location, size, depth, drainage, and tissue type; palpation of pedal pulses; and measurement of the ankle-brachial index. Atypical nonhealing wounds should be biopsied. The mainstay of treatment is the TIME principle: tissue debridement, infection control, moisture balance, and edges of the wound. After these general measures have been addressed, treatment is specific to the ulcer type. Patients with arterial ulcers should be immediately referred to a vascular surgeon for appropriate intervention. Treatment of venous ulcers involves compression and elevation of the lower extremities, plus exercise if tolerated. Diabetic foot ulcers are managed by offloading the foot and, if necessary, treating the underlying peripheral arterial disease. Pressure ulcers are managed by offloading the affected area.
Volume
101
Issue
3
First Page
159
Last Page
166
ISSN
1532-0650
Published In/Presented At
Bowers, S., & Franco, E. (2020). Chronic Wounds: Evaluation and Management. American family physician, 101(3), 159–166.
Disciplines
Medicine and Health Sciences
PubMedID
32003952
Department(s)
Department of Medicine
Document Type
Article