Ischemic Ulcers

By Susan Cleveland, BSN, RN, WCC, CDP, NADONA Board Secretary

Part 2 in a two-part series looking at the basics of correctly using support surfaces to help redistribute pressure. Read Part 1 here.

Temple University School of Podiatric Medicine Journal Review Club
Editor's note: This post is part of the Temple University School of Podiatric Medicine (TUSPM) journal review club blog series. In each blog post, a TUSPM student will review a journal article relevant to wound management and related topics and provide their evaluation of the clinical research therein.

Temple University School of Podiatric Medicine Journal Review Club
Editor's note: This post is part of the Temple University School of Podiatric Medicine (TUSPM) journal review club blog series. In each blog post, a TUSPM student will review a journal article relevant to wound management and related topics and provide their evaluation of the clinical research therein.

By Aletha Tippett MD

How do you know if you are making right choice for a patient? Or, how do you know if you are even making a choice? This is true in the world of limb salvage. I have witnessed too many patients for which the risk of amputation was too much, and they died. But how do you know what the outcome will really be? You never really know, but you can make your best guess.

By Aletha Tippett MD

I was recently talking to a young nursing student who told me she had had a terrible week and cried when she had to do wound care for a patient. When asked what the problem was she reported that her patient was an elderly man near death who had severe peripheral vascular disease with gangrene on both feet. He had severe pain whenever touched and she was instructed to wrap his legs with gauze and ace wraps.

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Arterial ulcers can cause much pain for patients and consternation for the wound care professionals tasked with managing them. Arterial ulcers can be a catch-22 in that many patients with arterial ulcers present with edema, but due to the nature of their problem cannot be safely compressed.

By Aletha Tippett MD

For a physician or nurse in wound care, the primary thing to remember is this: you are not just seeing a wound, you are seeing a person who has a wound. Do not lose sight of this human and their humanity. Always look at the whole picture of your patient, not just their wound. Find out what is important to them and for them. Your patient might tell you, “Doc, I don’t care about the wound, I just can’t stand the smell,” or “Doc, just cut my leg off because I can’t stand the pain.”

By Aletha Tippett MD

In my work with wounds, I frequently find the absence of a diagnosis of ischemia, or worse, I find a misdiagnosis. Ischemia is caused by severe obstruction of the arteries, which seriously decreases blood flow. If the arteries are in the heart, you will find a heart attack. If the arteries are in the brain, you will find a stroke. In the skin, you will find a wound.