Ulcers are a common problem in older people. It is convenient to treat the intervention of a doctor, it would be advisable that the pharmacist knew to recognize them derive. Antonio Sahuquillo, the Department of Dermatology at University Hospital and Polytechnic La Fe , Valencia, describes the ulcer as a loss of the entire epidermis and part of the dermis . The first manifestation is a redness that does not go away. “Clinically manifests excavated lesions yellowish, whitish or blackish background, according predominates fibrin (most common in venous ulcers) or necrosis (most common in arterial)”.
Sometimes you can find a well-defined edges rojovioláceos and the presence of erythema, eczema, fat atrophy or ocher dermatitis around.
EMERGING AREAS WHERE ULCERS
“As we are dealing with more sensitive skin and less ability to regenerate, the elderly are more prone to traumatic ulcers . However, the main stages are ulcers associated with cardiovascular disease, such as diabetes, venous insufficiency and arterial diseases most prevalent in the elderly , “explains Sahuquillo. In addition, older often have associated functional impotence. “It is not unusual that they enter hospital for long periods due to illness, which can lead to bedsores in areas of support.”
Also it emphasizes that the basal cell carcinoma is a type of nonmelanoma skin cancer often is in the form of ulcerated lesions.
All these factors influence the location of the ulcer. Sahuquillo explains that associated with diabetes are located on the ground standing still quite common among the heads of the first and fifth metatarsals or heel. In this case, usually painless. “Venous often appear to ankle level, either internal or external face and causing pain is variable. Arterial, however, usually the most distal, so that usually found in the fingertips and are described as very painful “.
PREVENTION BETTER THAN CURE
To prevent ulcers can follow these guidelines:
– Stimulating mobility of the individual.
– Make frequent postural changes.
– Inspect the condition of the skin once a day.
– Use devices to relieve pressure in elderly immobility (alternating pressure mattress, cushions, foam splints, water bags, etc.).
– Provide for nutrition and hydration to ensure the needs of calories, proteins and vitamins.
– Reduce environmental factors that cause dry skin, such as moisture.
– Avoid massage over bony prominences.
“In areas under pressure, is effective application hyperoxygenated fatty acids. Furthermore, the skin should be kept clean, preventing moisture and keeping hydrated “said expert.
MAINTAIN Aseptic zone
When despite preventive care, an ulcer arises must take into account its etiology. “In general, it may recommend a topical treatment to maintain clean and aseptic zone. This is achieved by avoiding the accumulation of devitalized tissue by washing with saline , debridement -whether by topical products or quirúrgicamente-, the use of disinfectants, topical antibiotics or dressings “. On oral antibiotics should be restricted warns that “in situations where suspected superinfection is high, in order to prevent future resistance to treatment.”
As a complement to skin care, recommends products with soothing and decongestant functions. Also “monitoring is important, it is imperative to rule out malignancy without any skin ulcer treatment response or torpid”.
Regarding the healing process, Sahuquillo recognizes that there is no set time. ” Each patient is completely different in the healing response ” may vary depending on the underlying pathology.