Leg ulceration Flashcards
What is a skin ulcer?
a skin break
with loss of the epidermis +
part/all of the dermis
What are the features of venous leg ulcers?
Large
Superficial
Gaiter area
Signs of chronic venous disease
May or may not be painful
What are the features of arterial leg ulcers?
Punched out with dry base
Necrotic
Over pressure areas
Painful
Symptoms of arterial disease
What are the two broad categories of causes of venous led ulceration?
Calf-pump failure and
Incompetent valves
What is the cause of venous calf-pump failure?
Neuromuscular dysfunction
What is the cause of incompetent valves in veins of the leg?
DVT
Thrombophlebitis
Childbirth
Orthopaedic/abdominal surgery
What are the associated signs of venous disease of the leg?
Varicose Veins Venous stars (spider veins) Venous ulcer Lipodermatosclerosis Atrophy blanche Pitting edema Scars
Other than the classical signs of venous leg disease (VVVLAPS) what else can occur?
Venous eczema
What are the three common complications of venous leg ulceration (what is the treatment)?
Superficial infection (topical antiseptics)
Cellulitis (oral/i.v. antibiotics)
Lymphoedema (compression)
How are venous leg ulcers managed?
Compression
Superficial venous surgery
Skin grafting
How are arterial leg ulcers managed?
Conservatively
Chemical lumbar sympathectomy
Angioplasty
Bypass surgery
What is particularly useful in diabetic ulcer management?
Wound debridement physically, chemically or via larvae therapy
What is the threshold for abnormal doppler and what does this indicate?
- 2 - misleading results, due to calcification in DM
0. 8
What causes ulceration in venous disease of the leg?
Loss of valve competency
Back pressure + oedema occur
Poor wound oxygenation leads to poor healing and predisposes to infection
What are the most common type of leg ulcer
Venous leg ulcers
