Approach To Chronic Leg Ulcers

Question 1

What’s the most common type of chronic lower limb ulcer?

Answer 1

Venous

Question 2

Commonest cause of venous ulcers?

Answer 2

CVI (chronic venous insufficiency)

Question 3

Explain the Fibrin Cuff theory of venous ulcers

Answer 3

Fibrinogen forms a cuff around capillaries, leads to interference with oxygen change and hence ischemia

Question 4

Where are venous ulcers common?

Answer 4

Gaiter region

Question 5

Where are ischemic ulcers common?

Answer 5

Toes

Question 6

Conservative Treatment of ulcers

Answer 6

Leg elevation, compression stocking/bandage

Question 7

Minimally invasive treatment of ulcers?

Answer 7

Injection foam scleropathy/ SEPS/ endovenous ablation.

Question 8

Where are arterial ulcers common?

Answer 8

Feet, head of the 1st and 5th metatarsals, and lateral aspect of the leg

Question 9

Compare arterial and venous site?

Answer 9

Venous is generally gaiter region, arterial is sites of trauma or pressure areas, like the heel, feet, so on.

Question 10

A leg ulcer is chronic after how long?

Answer 10

4-6 weeks.

Question 11

What ulcer type is commonly associated with punched-out edges?

Answer 11

Arterial ulcers

Question 12

What sign is specific to malignant ulcers in relation to their edges?

Answer 12

Everted and rolled edges

Question 13

What dressing type promotes autolytic debridement in ulcers?

Answer 13

Hydrocolloids