Leg Ulcers

Question 1

Define “chronic leg ulcer”

Answer 1

Any break in the skin of the lower leg, above the ankle, present for more than 4 weeks

Question 2

The majority of leg ulcers are arterial in nature. True/False?

Answer 2

False

Majority are venous ulcers

Question 3

List characteristics of a venous ulcer

Answer 3

Lipodermatosclerosis
Hyperpigmentation
Swelling
Superficial, located near malleolus/ gaitor area

Question 4

ABPI is measured for ulcer patients. What are the normal limits for ABPI?

Answer 4

0.8-1.3

Question 5

ABPI of less than 0.8 indicates what?

Answer 5

Vascular disease

Question 6

ABPI of more than 1.5 indicates what?

Answer 6

Calcification

Question 7

When would a wound swab of an ulcer be done?

Answer 7

If smelly/painful/exudative/enlarging - suspicious of infection

Question 8

Name 2 de-sloughing agents

Answer 8

Hydrogel

Honey

Question 9

What is the gold standard treatment for VENOUS leg ulcers?

Answer 9

Compression bandaging + non-adherent dressing

Question 10

Where do diabetic and arterial ulcers tend to present?

Answer 10

Feet
Pressure sites (heel)

Question 11

List risk factors for venous ulcers

Answer 11

DVT
Thrombophilia
Varicose veins
Immobility

Question 12

List risk factors for arterial ulcers

Answer 12

Smoking
Hypertension
DM
Hyperlipidaemia
Ischaemia

Question 13

List characteristics of a venous ulcer

Answer 13

Severe pain

Usually no swelling

Question 14

What investigations are typically done for ulcers?

Answer 14

ABPI

Duplex US

Question 15

What is the healing time aim for ulcers?

Answer 15

12 weeks