FN: Leg ulcers Flashcards
1
Q
Definition
A
Interruption in the continuity of an epithelial surface
2
Q
Causes
A
Venous: commonest Arterial Neuropathic: EtOH, DM Traumatic e.g. pressure Systemic diseasee.g. pyoderma gangrenosum Neoplastic SCC
3
Q
Venous description
A
- Painless, sloping, shallow ulcers
- Usually on medial malleoulus: :gaiter area”
- Association with haemosiderin deposition and lipodermatosclerosis
- RFs: venous insufficiency, varicosities, DVT, obesity
4
Q
Aterial description
A
hx of vasculopathy and RFs Painful, deep, punched out lesions Occur @ pressure points -heal - Tips of and between, toes -metatarsal heads (esp. 5th)
OTher signs oc chronic leg ischaemia
5
Q
Neuropathic
A
Painless with insensate surrounding skin
Warm foot with good pulses
6
Q
Complications
A
osteomyeltis
Development of SCC in the ulcer (Majorlins ulcer)
7
Q
Investigatins
A
BPi of possible
Duplex ultrasonography
Biopsy may be neccessary - look for malignant change: Marjolins ulcer
8
Q
Mx of venous ulcers
A
Refer to leg ulcer community clinic
Focus on prevention
-graduated compression stockings
- venous surgery
Optimise RFs: nutrition, smoking
9
Q
Specific Rx
A
Analgesia Bed rest + elevate leg 4 layer graded compression bandage (if ABPI >0.8) Pentoxyfylline PO - raised microcirculatory blood flow - Improves healing rates
10
Q
Other Mx options (no proven benefit)
A
Desloughing e.g. larval therapy, hydrogel
Topical antiseptics: iodine, Mauka honey
Split-thickness skin grafting may be considered
