Leg Ulcers Flashcards
What is the definition of a leg ulcer?
Open lesion between the knee and ankle joint that remains unrelated for at least 4 weeks
What can cause venous ulcers?
Venous hypertension DVT Obesity Varicose veins Reduced mobility Pregnancy Recurrent phlebitis
What can cause an arterial ulcer?
Claudication Narrowed arteries Calcified arteries Diabetes Hypertension Smoking Obesity
What are the symptoms of a leg ulcer?
Pain
Leakage
Smell
Recurrent infections
What are the different types of leg ulcer?
Venous Arterial Mixed Malignant Vasculatic Inflammatory Hydrostatic
What is hemosidrin?
Tanned leg in venous ulcers due to the leakage of haemoglobin to the skin surface
How is an ulcer assessed?
Position of ulcer (venous in baiter area over malleolus, arterial over calf)
Measure SA
ALWAYS do ABPI
If in toes, think diabetic neuropathy
What are the characteristics of a venous ulcer?
Shallow with flat margins
Often presents with slough at base with granulation tissue
Moderate to heavy exudate
What type of pain is associated with a venous ulcer?
Throbbing, aching, heavy feeling in legs
Improves with elevation and rest
What sort of pain is associated with an arterial ulcer?
Intermittent claudication
Worse at night
Improves with dependency
What are the characteristics of an arterial ulcer?
Punched out Irregular in shape Unhealthy appearance of wound bed Presence of necrotic tissue Low excudate
What is the condition of the leg likely to be like in a venous ulcerated leg?
Haemosiderin staining Thickening and fibrosis Dilated veins at ankle Crusty, dry, hyperkeratotic skin Eczemsatous itchy skin Pedal pulses present
What is the condition of an arterial ulcerated leg?
Thin, shiny, dry skin No leg hair Cold skin Pallor skin Absence or weak pedal pulses Delayed cap refill Gangrene
What are the different ranges for ABPI?
0.8-1.2 is normal
Less than 0.8 indicated problem
Over 1.3 indicated calcification
What investigations can be undertaken for a leg ulcer?
ABPI Wound swab Bloods (FBC, LFT, UE, CRP) Patch test if contact allergic dermatitis Duplex scan
