Have vascular studies been completed to determine the presence or absence of arterial disease? There are many issues associated with vascular ulcers, and just asking about the type of dressing is not the first step. Diagnosed Venous ulcers are usually associated with BLE edema, open draining painful wounds, venous stasis dermatitis with hygiene issues. All of these issues must be considered to determine the type of skin care/hygiene, wound care, and management of edema/compression therapy. Compression therapy is a standard treatment in the management of venous insufficiency and venous ulcers, but only if vascular studies/ABIs determine no arterial disease.
Arterial and diabetic ulcers need the assessment from a vascular surgeon and possibly a skilled podiatrist with appropriate vascular studies and scans to determine extent of vascular compromise, possible bone involvement, amount of necrosis in wound bed. (Sorry for this lengthy answer, but I realize that nurses are focusing on dressings before a full thorough assessment has been done with appropriate referrals. There are many references in wound care text books, journals, and online to provide a more comprehensive review of vascular ulcers).
Marlene Balik, BSN, RN, CWCN
In any wound of any etiology, there is no one or BEST dressing. Healing is multifactorial. Consider the patient's age, medical/surgical hx, pain tolerance, existing comorbidities. Once all is in place, they'll need testing. In the Venous/Arterial cases, they'll need Vascular Testing, depending on how aggressive they want to go. THEN, you'll find maybe 1 or 3 treatment plans in mind. Reading the most current breakthroughs about wound healing also helps. There are so many new products now, some might work for some and some might delay wound healing for some. There's no ONE BEST dressing for any wound. History is key, along with patients'compliance.
It’s very important to get the appropriate dressing for the amount of exudate. Venous ulcers generally drain a large amount so you need a more absorbent dressing. This will prevent a “wet” dressing from just sitting on the ulcer. It will also require more frequent changes. Arterial ulcers are generally dry. These can be treated with simple dressing to protect the areas or even painted with 10% betadine if ulcers are in on the feet or toes.
It depends on the exudate and presence of granulation eschar or slough
kal potassium intravenous via iv skill nursing duty care for emergency or op/ip for vitamins of kal potassium over aging for preventive pain management type of nursing care(s) duties.
Antibiotic if needed, debridement and colloid dressing.
