Treatment

When the ulcer is caused by a systemic disease, the disease must be treated along with the injury. If one doesn’t get better, the other won’t either, so the treatment is combined. Depending on the degree of contamination of the ulcer, different therapeutic approaches can be used. In a clean ulcer, you can see pink, healthy tissue without discharge of liquid and without particular odors. This type of lesion is important to keep clean and observe its evolution every four or five days, measuring it with a tape measure.

Antibiotic ointments, such as bacitracin, help keep the ulcer hydrated and uncontaminated, which helps it heal. Gels with hydrocolloid components, such as Duoderm, are excellent for accelerating the granulation process and new skin formation. There is no special technique for applying these products; just keep the lesion clean and dry before placement, and make sure to fill the entire surface of the ulcer. The ulcer must be kept covered with gauze impregnated with the product you decide to use. Contaminated ulcers are the ones that are more complicated to treat. The degree of infection and the patient’s condition should be assessed. Recognizing these wounds is easy as they usually have a yellow-green background; some secrete a lot of fluid or pus, and the material can be fetid. These sores must be kept clean. Some must be cleaned even two and three times during the day. It all depends on how quickly the secretions build up there. Sacral sores are some of the ones that get infected quickly once they form. This happens in bedridden patients who keep this area moist by wearing a diaper, where stool and urine accumulate. Even in the most careful and clean patients, it is quite difficult to keep this area completely dry. For these cases, patches containing silver alginate are ideal because they absorb secretions and promote tissue formation. The dressing should fill the cavity completely. The necessary amount should be used, especially in those ulcers that are excavated. A gauze dressing or wound pad should be placed over the patch to isolate the area being treated. Patches should not be changed daily unless they are heavily soaked in fluid.

AfroBrazilian, Own work, CC BY-SA 3.0