Leg ulcers Flashcards
what is the main cause of venous (80%) leg ulcers
venous disease (varicose veins, brown staining)
what is the main cause of arterial (20%) leg ulcers
arterial disease
what are the 7 risk factors for leg ulcers (3 are conditions)
increasing age smoker immobility nicorandil rheumatoid arthritis diabetes vasculitis
what is the ABPI in venous leg ulcers
low
what is the ABPI in arterial leg ulcers
low
how do venous leg ulcers present (3)
dermatitis
hyperpigmentation
woddy tethered skin from haemosiderin deposits
where do venous leg ulcers present
gaiter area (between knee and ankle) and around malleoluses
how do arterial leg ulcers present (2)
‘punched out’ lesion
absent pulses
where do arterial leg ulcers present
around foot/ankle
what mechanism is associated with pyoderma gangrenosum (type of leg ulcer)
necrotic tissue (from inflammatory disease etc)
how does pyoderma gangrenosum present
deep painful ulcers
how does a leg ulcer associated with vasculitis present
necrotic
sudden onset
pain
purpuric rash
how does a leg ulcer associated with diabetes present (arterial/venous)
arterial/venous - absent pulses, dorsal foot,
neuropathic (more serious and more common) - necrotic, plantar foot, gangrenous
what investigations are carried out for all leg ulcers
ABPI (ankle BP/arm BP to see if arterial disease)
wound swab only if infected/painful
treatment of low severity leg ulcers
clean with tap water and soap
refer to specialist nurse
compression stockings (if ABPI between 0.8-1.3)
leg elevation
