Leg ulcers

Question 1

name the 7 types of leg ulcer?

Answer 1

Venous 
arterial
diabetic
Vasculitic
Malignant
Hydrostatic
mixed arteriovenous

Question 2

Assesing a leg ulcer

• hx
• PMH
• ulcer itself
• investigations

Answer 2

hx

• duration, first ulcer?
• pain- disturbing sleep/mobility

PMH
-varicose veins, DVT, clotting issues, PVd, arterial disease and diabetes

ulcer:
measure SA and position
superficial or deep
examine whole leg- venous or arterial disease

Presenting with ulcer
measure ABPI
normal- 0.8-1.3
vascular disease- 1.5
arterial disease

Question 3

treatment of venous ulcer?

Answer 3

pain management- neuropathic pain
non-adherent dressing
De sloughing agent if necessary e.g. hydrogel
4 layer compression bandaging- cone shape
leg elevation
dressings- hydrocolloids, antibacterial
compression stocking after ulcer healed

Question 4

venous dermatitis

• sign of?
• appearance?
• treatment?

Answer 4

• might be precursor to an ulcer occurring due to venous stasis
• itchy, thickened, hyperkeratotic skin
• topical steroids, emollients, compression

Question 5

appearance of venous ulcer vs arterial ulcer?

• site
• edges
• wound bed
• size
• exudate
• pain

Answer 5

venous

• medial gaiter region
• sloping and gradual
• covered with slough
• large
• high
• minimal

Arterial

• toes foot and ankle
• punched out and well defined
• slough + necrotic tissue
• small
• low
• yes