Leg ulcers

Question 1

What are the four main types of ulcer?

Answer 1

• Arterial
• Venous
• Neuropathic (diabetic)
• Pressure

Question 2

Arterial ulcers occur secondary to which condition?

Answer 2

Peripheral arterial disease

Question 3

Venous ulcers occur secondary to which condition?

Answer 3

Chronic venous insufficiency

Question 4

Which complication is important to consider in a patient with a neuropathic ulcer?

Answer 4

Osteomyelitis

Question 5

Which scoring tool is used to assess the risk of a patient developing pressure ulcers?

Answer 5

Waterlow score

Question 6

Describe the typical features of an arterial ulcer

Where do arterial ulcers typically occur?

Answer 6

• Small
• Deep
• Well defined border (“punched out” appearance)
• Painful (more painful than venous)

Distally - typically affecting the toes or dorsum of the foot

Question 7

Describe the typical features of a venous ulcer

Where to venous ulcers typically occur?

Answer 7

• Large
• Shallow
• Irregular, gently sloping border
• Less painful than arterial ulcers (but more likely to bleed)

Gaiter area

Question 8

Describe the management of arterial ulcers

Answer 8

Urgent referral to vascular (for consideration of surgical revascularisation)

Question 9

Describe the management of venous ulcers

Answer 9

Similar to management of chronic venous insufficiency, plus…

• Wound care (cleaning, debridement, dressing)
• Referral to vascular surgery may be indicated