Leg Ulcers Flashcards
what kind of leg ulcers can you get?
- venous
- arterial
- mixed arterio-venous
- diabetic
- vasculitic
- malignant
- hydrostatic (dependant limb)
- NB all ulcers are multifactorial
which two details should yo make sure to record about an ulcer?
- position of ulcer
- measure surface area
what is lipodermatosclerosis?
refers to a skin change of the lower legs that often occurs in patients who have venous insufficiency
what would make you think it was a venous ulcer?
- lipodermatosclerosis
- hyperpigmentation
- malleolus placement
what investigations would you do for a leg ulcer?
- ABPI
- would swab
- bloods
- patch testing
- duplex scan if indicated
when would you do a wound swab?
only if ulcer is increasingly painful, exudative, smelly, enlarging
what allergy would you patch test for?
allergies to previous ulcer treatments
how would you treat a venous ulcer?
- control pain
- ABPI
- non-adherent dressing
- de-sloughing agent if necessary (hydrogel/honey)
- 4 layer compression bandaging
- leg elevation
what else would you need aside from a dressing?
- absorption: hydrocolloids
- antibacterial: silver/iodine or manuka honey
how many classes of compression stockings are there?
1 (weak) to 3 (strong)
what class of compression stocking do most patients wear?
class 2 stockings
what kind of edge do venous ulcers tend to have?
a shallow edge, like a beach
what kind of edge do arterial ulcers have?
may have sharp, cliff-like edges, “punched out”
where are diabetic & arterial ulcers often found?
feet, especially around pressure sites such as heel or where shoes rub
what should you always do when deciding what type of ulcer it is?
ABPI
