What is a venous leg ulcer?

Venous leg ulcers are wounds that occur on the lower due to improper functioning of the venous valves and the calf muscle pump. Venous ulcers develop mostly along the medial distal leg and are a major cause of chronic wounds. Recommend treatment for venous insufficiency is compression therapy.

What is Compression Therapy?

Compression therapy is used for venous leg ulcers it increases the blood vessel valve effectiveness, preventing blood from flowing backwards. It is also used to decrease the release of inflammatory cytokines, lower the amount of fluid of leaking from capillaries and therefore prevent swelling, and prevent clotting. Compression is applied by using specialized bandage systems and stockings.

What is a arterial leg ulcer?

Arterial ulcers are caused by lack of blood flow to the capillary beds of the lower extremities. When pressure is placed on the skin, the skin is damaged and is unable to be repaired due to the lack of perfusion. The wound has a characteristic deep punched out looked, often extending down to the tendons. Arterial wounds are very painful.

What is a diabetic foot ulcer?

Diabetic foot ulcer is one of the major complications of Diabetes, and probably the major component of the diabetic foot. It occurs in 15% of all patients with diabetes and precedes 84% of all lower leg amputations. Major increase in mortality among diabetic patients, observed over the past 20 years is considered due to the development of macro and micro vascular complications, including failure of the wound healing process. (http://en.wikipedia.org/wiki/diabetic_foot_ulcer)

What is Lymphoedema?

Lymphoedema is swelling, usually in the arms, or legs, caused by an abnormal accumulation of lymphatic fluid. Lymphoedema can occur if the lymphatic drainage system is damaged, blocked, under developed or surgically cut. It is most common in the arms and legs, but may occur anywhere in the body depending on the underlying cause. Lymphoedema is a chronic condition which can improved with good treatment.

How is Lymphoedema treated?

Treatment usually consists a combination approach of the following:

  1. Manual Lymphatic Drainage (from a specially trained Lymphoedema Therapist)
  2. Compression bandaging and/or compression garments
  3. Special exercises, including self massage, breathing exercise and movement.
  4. Pneumatic compression limb drainage systems
  5. Kinesio taping where appropriate
  6. Skin care

How do you check if you have sufficient blood flow in your legs?

Arterial insufficiency can be diagnosed by doing a simple test called an ankle-brachial-pressure index (ABPI). This test measures blood flow by comparing blood pressure in your arms with blood pressure in your legs. This test can be performed manually by a qualified health profession or by using the ABILITY Doplex device.

What is the ABILITY device?

The ABILITY diagnostic device is a specialised device that is used at the Advanced Lower Limb and Wound Management Centre to determine your ABPI. This device allows the health practitioner to do the test in less than 8 minutes for both legs, where the normal manual test can take up to 30 minutes per leg.

What is granulation tissue?

Granulation tissue is collagen rich tissue which forms at the site of an injury. As the body heals this tissue fills in the injury and will eventually be covered by scar tissue (epithelial tissue).

When is a wound infected?

Wound infection develops when bacteria gets into the wound and attached to the tissue. The bacteria will grow and will keep the wound from healing. Wound infection signs include redness, swelling, increase in exudate or change in exudate colour, increased pain, bleeding, odour or wound breakdown. If you see any of these signs rather consult the clinic.

What do I use to clean my wound?

If the wound is not infected you can use normal drinkable tap water or normal saline (sodium chloride 0.9% solution). If there are signs of infection or the wound is contaminated by foreign debris you can use diluted antiseptics such as Dettol or Savlon to initially clean the wounds.

When do I need to see a wound care specialist?

When your wounds are not healing or you have underlying diseases such as Diabetes, Cancer, Lymphoedema, venous incompetence, arterial disease. Any wounds that does not respond to the normal band aid or plaster.

What is chronic wound?

A chronic wound is a wound that does not heal in a predictable amount of time normally 14 days as most wounds do. If a wound has not healed within 3 months is classified as a chronic wound. The most important thing about chronic wounds is that you first need to determine the cause of the wound (the reason why) in order to facilitate healing.

Why do you use Total Contact Casting (TCC) to treat diabetic foot ulcers?

Total contact casting is regarded world wide as the best way to facilitate total offloading of pressure in the diabetic foot when a patient has a diabetic foot ulcer. Since the cast is made from fibre glass it is light weight but strong and durable when applied by a trained health professional. The cast can be removed and re-applied to check the wound. This also saves time on frequent dressing changes and it is often only removed once a week.

What is moist wound healing?

This is the method in which wounds are healed by using advanced wound care products. The best way to heal wounds is to cover them with the right dressing as this will facilitate faster closure than leaving a wound open to dry out. Moist wound healing is the modern dressing approach. Dressings are made in such a way that it mimic’s the function of our normal skin in protecting the body from harm and facilitating healing. Wounds heal much faster in a moist wound healing environment than in a dry environment since the epithelial cell can migrate easily over a moist surface. Cells proliferate in a moist environment and struggle to grow in a dry environment.

Will my medical aid pay for the treatment?

At the practice we submit an authorization request to your medical aid which aids in the reimbursement process. The practice is however not contracted by any medical aid even though we charged the recommended medical aid tariffs. Patients are responsible for settling their accounts and then to claim back from their own respective medical aids. At the practice we also send regular progress reports to the medical aids and health professionals involved.

Do I need to be referred by my doctor for treatment?

No, you do not need to be referred, you can make an appointment directly at our centre. Once the initial assessment is done we will discuss and liaise with the relevant team members. We do encourage the primary physician to stay involved in the treatment.

Do you only treat wounds on the lower limb?

We specialise in the management of the lower limb but we do see all types of wounds. Wounds treated at the centre includes Breast Cancer wounds, Burn wounds, Abscess formation, lacerations, skin tears, finger injuries and a wide variety of complicated or non-healing wounds.

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