Patient Teaching Points: Vascular Ulcers

Patients with arterial and venous ulcers may inadvertently neglect their wounds or fail to use effective preventive measures if they do not understand the nature of their condition. They need to know about wound pathology and treatment rationales, as well as how to recognize changes that indicate problems with healing.

Education of patients and their families should also include assessment of educational needs and level of understanding. Teaching methods vary and should be chosen to facilitate the most appropriate method for the patient and family.

In general, patients with arterial ulcers should be taught to:

* monitor arterial or graft patency by palpating pulses

* recognize signs and symptoms of graft failure and what to report to the health care provider

* avoid nicotine in any form

* begin or maintain a regular exercise program

* manage their blood glucose level, if diabetes is present

* control hyperlipidemia

* manage hypertension

* reduce weight, if indicated

* perform meticulous foot care

* manage ulcer care.In general, patients with venous ulcers should be taught to:

* monitor the skin for cracking, ulcers, and changes in color and temperature

* use prescription compression stockings

* wear clean stockings daily

* ambulate with stockings on

* avoid extreme temperatures to the skin

* avoid constricting clothing around lower extremities

* maintain ideal body weight

* limit salt intake

* avoid smoking

* protect the lower extremities from trauma

* avoid prolonged standing or sitting

* elevate the feet higher than the heart whenever possible during the day.

Source: Sieggreen MY, Kline RA. Vascular ulcers. In Baranoski S, Ayello EA, editors. Wound Care Essentials. Philadelphia, PA: Lippincott Williams & Wilkins; 2004.