Wound Care

216 Nurse to Nurse
• Treatment
— Biopsy (best when taken from early purpuric lesions)
2 to 3 sites may be necessary for diagnosis
— Control underlying disease
— Steroids
— Immunosuppressive therapy
— Plasmapheresis in severe cases to remove circulating immune
complexes
— Topical treatment
Debridement of necrotic and devitalized tissue
Identification and treatment of infection
Moist wound bed
Absorption of excess exudate
Pack dead space
Insulate and protect from additional trauma
Topical application vitamin A to counteract steroid therapy
antiinflammatory effects
Rheumatoid Arthritis
• High levels of rheumatoid factor
• Rheumatoid nodules typically on hands and elbows
• Venous insufficiency symptoms
— Decreased ankle movement leads to poor calf muscle
pump function that increases patient risk for developing
venous ulcers
• Initially palpable purpura and ecchymosis which may
progress to ulceration
— Shallow, well demarcated, painful
— Slow to heal
• Compression therapy may be necessary if the limb is edematous
from venous insufficiency