Neobook — clinical reference

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ICD 10 code: L97

DESCRIPTION

A chronic relapsing disorder of the lower limbs
Associated with vascular insufficiency (predominantly venous insufficiency) and patient immobility
Commonly associated with neuropathy, infections, neoplasia, trauma or other rare conditions

GENERAL MEASURES

If the ulcer is oedema- or stasis-related, rest the leg in an elevated position
In venous insufficiency, compression (bandages or stockings) are essential to achieve and maintain healing, provided the arterial supply is normal
In patients with arterial insufficiency, avoid pressure on bony prominences and toes
In patients with neuropathy, relieve pressure from the area
Exclude diabetes with finger prick blood glucose test
Avoid topical application of home remedies
Stress meticulous foot care and avoidance of minor trauma. Encourage patients with neuropathy not to walk barefoot, check their shoes for foreign objects, examine their feet daily for trauma and to test bath water before bathing to prevent getting burnt
Avoid excessive local heat
Walking and exercises are recommended

MEDICINE TREATMENT

Refer for assessment and initiation of treatment

Local wound care

Topical cleansing:

Use bland, non-toxic products to clean the ulcer and surrounding skin

For clean uninfected wounds:

Sodium chloride, 0.9% or sterile water

Dressed frequently with:

Moistened dressing e.g. gauze with Sodium chloride 0.9%

LoE: IIIb⁸

For exudative, infected wounds:

Povidone-iodine 5% cream, topical apply daily

LoE: IVb⁹

For venous ulcers:

Paraffin gauze dressing

REFERRAL

No improvement after 1 month
All foot ulcers
Ulcers with atypical appearance
Venous ulcers that are persistently infected, or have offensive odour

Click here to access the pdf.

Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_07 November 2024

Chapter 5: Skin Conditions_5.4.4 Chronic Lower Leg Ulcers

Chronic Lower Leg Ulcers

Drugs mentioned

ICD-10 codes