Leg Ulcers Flashcards
what is a leg ulcer?
open lesion between knee and ankle that remains unhealed for at least 4 weeks
how long does a lesion have to be open and unhealed before it is classed as an ulcer
4 weeks
most common type of leg ulcer?
venous
causes of ulcers other than venous/arterial
rheumatoid arthritis diabetes vasculitic malignancy inflammation hydrostatic
who is at risk of a hydrostatic ulcer
heart failure
COPD
orthopnoea
what is lipodermatosclerosis?
hardening, scaling and redness and pain of the lower leg;= can precede to ulcers
which type of disease causes a hyperkeratotic limb around the ulcer?
venous
how to tell the different between venous dermatitis and venous ulcer?
itch?- VD
bilateral?- VD
common sites for an arterial ulcer to present?
shin
foot
toe
how does an arterial ulcer differ in appearance from venous
cold
can’t palpate pulses
doesn’t look as red
what does necrobiosis lipoidica look like?
venous ulcer-like
telangectasia
plaques around it
who gets necrobiosis lipoidica
diabetic patients
what does pyoderma gangrenosum look like?
blackish border
dark red colour
who gets pyoderma gangrenosum
crohn’s patients
causes of blood stasis?
varicose veins \++ fat vasoconstrictors PVD (poor arterial supply) cold weather \++ fibrin
appearance of vasculitis?
purpuric rash/pustules
necrosis
why do we do ABPI?
establishes if there is arterial disease
why would you do a patch test for ulcers?
test bandage/dressing allergies
normal ABPI value?
1
what ABPI values would you use compression for?
0.8-1.3
what ABPI values would indicate vascular disease?
<0.8
what ABPI values would indicate calcification?
> 1.5
how would you treat a venous ulcer?
analgesia dressing de-sloughing eg honey/hydrogel 4 layer compression elevation
using 4 layer compression, how long would the ulcer take to heal?
12 weeks
4 ways of getting rid of necrotic tissue?
surgery
larvae therapy
scissors/scalpel
dressings (autolytic)
