Gangrenous Ulcer (Eng/Kor) for NCLEX

Gangrenous Ulcer

 

1. Definition (정의)

English:

A gangrenous ulcer is a skin ulcer (open sore) that has progressed to gangrene, meaning the tissue has died due to loss of blood supply, severe infection, or both. It often appears black, foul-smelling, and necrotic.

Korean:

괴저성 궤양은 피부 궤양(상처)이 혈류 차단이나 심한 감염으로 인해 조직이 죽어(괴사) 괴저로 진행된 상태를 말합니다. 검게 변하고 악취가 나며 죽은 조직이 보이는 것이 특징입니다.

2. Causes (원인)

English:

• Peripheral arterial disease (PAD)
• Diabetes mellitus
• Severe infection
• Pressure ulcers (stage IV)
• Trauma with compromised blood flow
• Frostbite
• Vascular occlusion (clots)

Korean:

• 말초 동맥 질환
• 당뇨병
• 심한 감염
• 욕창(4단계)
• 혈류가 감소된 외상
• 동상
• 혈관 폐색(혈전)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Clinical Manifestations (증상 / 특징)

English:

• Black, brown, or dark green necrotic tissue
• Foul-smelling discharge
• Severe pain (may decrease after tissue death)
• Cold, dry, or shriveled skin around area
• Possible fever or sepsis signs
• Poor peripheral pulses or slow capillary refill

Korean:

• 검정/갈색/녹색 등의 괴사 조직
• 악취 나는 분비물
• 심한 통증(조직이 죽으면 통증 감소 가능)
• 주변 피부가 차갑고 마른 느낌
• 발열 또는 패혈증 가능
• 말초 맥박 약함, 모세혈관 재충혈 지연

4. Diagnosis (진단)

• Physical examination
• Wound culture
• CBC, CRP, ESR
• Doppler ultrasound (blood flow)
• Imaging: X-ray or MRI to check for osteomyelitis

5. Treatment (치료)

A. Non-medication / Non-surgical (비약물/비수술)

• Wound cleansing and debridement (제거)
• Offloading pressure
• Strict blood glucose control (diabetic pts)
• Improve circulation (warmth, avoid tight shoes)

B. Medications (약물)

• Broad-spectrum IV antibiotics
• Pain medications
• Vasodilators if indicated

C. Surgical options (수술)

• Surgical debridement (괴사조직 제거)
• Revascularization surgery for blood flow
• Amputation (if severe, not salvageable)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. Nursing Considerations (간호 중재)

English:

• Assess wound color, odor, drainage
• Monitor for sepsis (fever, tachycardia, hypotension)
• Pain management
• Strict aseptic wound care
• Encourage perfusion: keep warm, no compression
• Educate about foot care (especially diabetes)
• Monitor blood glucose
• Ensure proper nutrition (protein, vitamin C, zinc)

Korean:

• 상처 색, 냄새, 분비물 사정
• 패혈증 징후 관찰
• 통증 관리
• 무균적 상처 관리
• 혈류 개선(따뜻하게, 압박 금지)
• 발 관리 교육(특히 당뇨 환자)
• 혈당 모니터링
• 단백질/비타민 C/아연 등 영양 제공

7. Patient Teaching (환자 교육)

• Seek immediate care for new wounds
• Avoid smoking (worsens circulation)
• Keep blood sugar controlled
• Do not walk barefoot
• Inspect feet/legs daily
• Report black or cold skin early