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Skin protection in wound management

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Nurses are crucial in managing skin around wounds Nurses are crucial in managing skin around wounds

The incidence of leg ulcers increases significantly with age. Leg ulcers may be classed as one of two types: arterial, which are due to peripheral vascular disease, and venous, which are due to underlying venous hypertension.

Although managing a patient with a venous ulcer tends to focus on choosing appropriate dressings and applying compression bandages, managing the patient's surrounding skin is also important. Failure to manage the surrounding skin may result in further skin breakdown and severe discomfort.1

Leg ulcers occur when the valves in the deep and perforating veins become incompetent and allow a back flow of blood into the superficial veins. The back flow of blood then pools around the ankles, and results in abnormally high pressures in the lower leg veins of 90 mmHg and above (normal pressure is 30 mmHg), causing venous hypertension.2 High pressures in the lower leg result in oedema. Various skin problems can then result from this oedema, including ulceration.

The main treatment for venous leg ulceration is the application of compression bandages. Compression forces the blood in the lower legs back into the main venous system, which lowers the high pressures and improves healing.

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