Friday, January 26, 2018

Causes of a Non Healing Ulcer : Summary

Hi everyone !

This is a short summary on what causes an ulcer to have delayed healing.
Most cases in the wards and the boards are Traumatic ulcers that have now failed to heal due to some or the other reason. Most commonly the reason is Diabetes , other common ones including Poor general health and Varicose veins.
This post summarises the causes.

Causes of Non healing ulcer

Local :
- Site of high pressure / mobility
- Repeated trauma to site
- Foreign body at the ulcer base
- Local infection at ulcer site

Focal :
- Varicose ulcer (Generally at the Medial malleolus)
Reason : Venous congestion eventually causes the trapped macrophages etc to release their mediators producing Inflammatory changes + Pigmentary changes occur due to microruptures of congested venules causing Hemosiderin formation and irritation of skin by the Pigment.
- Deep Vein Thrombosis (Same as above).
- Peripheral Arterial Disease ( Arterial blockade -- causes tissue Hypoxia and thus impaired healing ) 
- Neuropathy ( Impaired sensations cause repeated trauma at the site of the ulcer delaying its healing ).
- Lymphatic D's ( Lymphedema -- can cause skin hypertrophy and other odd changes due to mediators from the Lymph causing ulceration)

Systemic :
- Malnutrition
- Anemia
- Low proteins
- Vitamin deficiencies - esp Vit C , K
- Diabetes Mellitus
- Hypertension (Martorell Ulcer)


Why Diabetes causes non healing of any ulcer ?
3 important reasons :
- Microangiopathy : Due to deposition of various Glycated end products into the microcirculation causing Hypoxia and thus impaired healing
- Neuropathy : due to diabetic Neuropathy , the sensations to the area may be diminished and this will cause repeated trauma to the ulcer.
- Infections : High glucose levels serve as a pabulum or conducive manure for growth of various microbes.  Infection causes impaired healing of the ulcer.

Hope this was helpful!
Happy Studying!
Stay awesome !
~ A.P. Burkhodleria

1 comment:

This is express yourself space. Where you type create something beautiful! <3
Wondering what do I write? Well...
Tell us something you know better. You are a brilliant mind. Yes, you are! ^__^
Ask about something you don't understand @_@?
Compliment... Say something nice! =D
Be a good critic and correct us if something went wrong :|
Go ahead. Comment all you like here! (:

PS: We have moderated comments to reduce spam. ALL comments that are not spam will be published on the website.