Ulcer

From ArticleWorld

An ulcer is a non-traumatic sore in the skin, eyes or mucus membranes of the body. Ulcers are generally started as an abrasion or area of pressure to the tissues that becomes inflamed, breaks down the natural barrier and sometimes becomes infected. Ulcers are more common in those who are elderly or who have weakened immune systems.

Pathophysiology

Skin ulcers are the most common type of serious ulcers in the body. They often begin in areas such as the heels, the bony prominences of the feet and the body prominences of the buttocks, such as the sacrum. Excessive pressure and abrasive action begin to cause the skin to become reddened. The skin often hardens at the site of the pressure and can form blisters. If allowed to continue, the skin and underlying tissue that is inflamed, loses adequate circulation and necrosis (tissue death) begins.

The skin falls away or forms a blackened covering over other tissues. Eventually the underlying fat is lost. The muscle can be exposed and becomes under pressure as well. Eventually, the muscle becomes necrotic and the area can become so deep that the bone is involved.

Complications

Ulcers are often perpetuated by infection by bacteria or fungal organisms. The organisms that cause this problem are extremely difficult to treat as there are often several organisms involved and they are often resistant to multiple antibiotics. Systemic infection can result or the infection can spread, leading to further tissue damage. Because skin ulcers are, in part, due to loss of circulation to an affected area, a simple ulcer can be so difficult to heal that amputation or surgical debridement of the area is necessary to cut away dead or devitalized tissue.

Prevention

Many ulcers occur in high risk patients with poor circulation, diabetes, immune deficiency and immobility. Improving the circulation or the individual’s diabetic status can sometimes help prevent ulcers. Many times, immobile people need to have something, such as lambs wool or other soft material, placed over prominences to protect high risk areas. Frequent turning in bed or changing from a sitting to a lying position so that high risk areas are not subject to direct pressure is the most common form of prevention recommended.