surgical management
Last reviewed 01/2018
Surgical management entails:
- removal of all slough and necrosis from wound as it hinders the growth of underlying granulation tissue; satisfactory debridement is indicated by fresh capillary bleeding
- wound should be repeatedly re-examined and further slough removed
- assessment for the presence of abscess communicating with ulcer base:
- it should be entered, its walls broken down, and the cavity packed
- antibiotic cover is required, as is the case if cellulitis is seen around the ulcer margin
- resistant ulcers may benefit from reconstructive surgery:
- rotational skin flaps for buttocks
- split skin grafts for heals
- dressings; alternatives include:
- gauze roll replaced regularly
- silicone foam elastomer, washed and replaced regularly