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
when should you aim to heal simple venous ulcers by?
12 weeks
