Stasis Ulcers
Posted on April 16, 2010 in Coding Education
by Ann Giles, RN, BSN, HCS-D, COS-C
Some of the most frequently misidentified /miscoded types of wounds are stasis ulcers. It is important to understand the etiology behind the ulcers when identifying a wound. In patients with venous stasis disease, the valves in the veins become incompetent. The incompetent valves cause an increase in the amount of fluid in the veins. The increased amounts of fluid then causes increased pressure. The increased pressure then causes fluid and red blood cells to "leak out" into the surrounding tissue. This "leakage" causes edema and hemosiderosis, which is the brown/blackish discoloration of the lower extremity. This discoloration is caused by the breakdown of the RBC's/hemoglobin that leak into surrounding tissue. If not controlled, the increased pressure can cause the tissue to begin to break down - a stasis ulcer.
Now that you know the disease process behind the ulcer, let's discuss the actual wound characteristics. Location, location, location! Venous stasis ulcers are located in the gaiter area, from the ankle to below the knee. You will never see stasis ulcers on the toes! These wounds will be full thickness wounds with no visible structures or necrotic tissue. The wound edges will be irregular. These wounds are not painful. And finally, the hallmark sign of a stasis ulcer is the large amount of exudate. If a patient has symptoms of venous stasis disease and a wound that meets this description call the MD for clarification. Properly identifying wounds is the first step in treating them.
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Thanks, Ann. That was very helpful.
By Gerri Shook on Apr 19, 2010 at 08:00 am
Good info
By Phyllis Maxwell on May 18, 2010 at 11:58 am
Excellent description! Hope all field nurses will read and understand. Thanks.
By Lois Kinsella on May 19, 2010 at 05:43 am
Thank you for the excellent description.
By Froyla Alden on May 19, 2010 at 11:17 am
Thanks. This is a situation that nurses seem to struggle with no matter how much teaching you do with them. You put it down in writing with the reason behind it.
By Peggy Sohn on May 20, 2010 at 08:06 am