leg ulcers Flashcards
which types of analgesia should be avoided in venous leg ulcers?
NSAIDS can make things worse
how is the management of venous ulcers?
Compression therapy is used to treat venous ulcers (after arterial disease is excluded with an ABPI).
Pentoxifylline (taken orally) can improve healing in venous ulcers (but is not licensed).
Antibiotics are used to treat infection.
Analgesia is used to manage pain (avoid NSAIDs as they can worsen the condition).
how does management of arterial ulcers differ from venous ulcers?
Debridement and compression are not used in arterial ulcers.
if arterial ulcer is present there should be an urgent referal to surgeons for revascularisation
what are features of arterial ulcers?
- Are smaller than venous ulcers
- Are deeper than venous ulcers
- Have well defined borders
- Have a “punched-out” appearance
- Are pale colour due to poor blood supply
- Are less likely to bleed
- Are painful
- Have pain worse at night (when lying horizontally)
- Have pain is worse on elevating and improved by lowering the leg (gravity helps the circulation)
where does arterial ulceration usually occur?
distally, affecting the toes or dorsum of the foot
and maleolus
where do venous ulcers typically occur?
Occur in the gaiter area (between the top of the foot and bottom of the calf muscle)
above the maleoulus
what skin changes are associated with venous ulcers?
hyperpigmentation, venous eczema and lipodermatosclerosis
how do venous ulcers differ from arterial ulcers?
- Are larger than arterial ulcers
- Are more superficial than arterial ulcers
- Have irregular, gently sloping border
- Are more likely to bleed
- Are less painful than arterial ulcers
- Have pain relieved by elevation and worse on lowering the leg
