Ulcers are open sores on the skin which occur when the outer layers of the skin are injured and the deeper tissues become exposed. They can be caused by excess pressure due to long periods of bed rest, ill-fitting shoe-gear, or after an injury that breaks the skin. Ulcers are often seen in patients who have circulation problems, lack of sensation, and/or diabetes. Ulcers can put patients at increased risk of developing infection in the skin and bone.
Signs and symptoms of ulcers may include: odor, drainage, and lack of continuity of the skin. If infection is present, redness, swelling and pus may be seen. Pain may or may not be present. Diagnosis may include x-rays to evaluate possible bone involvement. Other advanced imaging modalities may also be ordered to assess the patients circulatory status, which may affect a patient’s ability to heal the wound.
Ulcers are often treated by removing the devitalized tissue and performing local wound care to assist in healing, as long as circulation is adequate. Specially prescribed offloading padding and shoes may be used to remove excess pressure on the area. If infection is present, antibiotics will be necessary. In severe cases that involve extensive infection or are slow to heal, surgery or other advanced wound care treatments may be necessary.