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Updated: Dec 27, 2025

Application of Lucilia sericata Larvae in Debridement of Pressure Wounds in Outpatient Settings
Published on: December 4, 2021
Review of local wound management for scleroderma-associated digital ulcers
Nicholas Lebedoff1, Tracy M Frech1,2, Victoria K Shanmugam3
1Uiversity of Utah, Department of Internal Medicine, Salt Lake City, UT - USA.
Abstract:
Digital ulcers (DU) are a common clinical problem in systemic sclerosis (SSc); however, there is no standardization of local wound care protocols for management of these lesions. There is a well-recognized need to develop and standardize non-pharmacological management of DU in patients with SSc, and to adopt these protocols in future clinical trials that focus on DU healing. The purpose of this review is to outline the types of DU that occur in SSc, and provide an update on the principles of wound management for these lesions based on the current literature and expert opinion.
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Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...

