Leg Ulcers Flashcards
Define:
Ulcer
Erosion
Discontinuity of skin with complete break in epidermis and possibly dermis and SC tissue
Partial break in epidermis - appears bright red and weepy
Causes
Types
Trauma
Internal pathology
Arterial
Venous
Vasculitis
Neuropathic
Investigation of causes:
Arterial disease
DM
Neuropathic ulcer
Venous insufficiency
What could FBC, U&E and ESR show signs of?
What should be done to investigate if it appears infected?
ABPI
Urine glucose
Test skin sensation and vibration
Doppler USS
Vasculitis
Infection
Arterial disease
Swab
Management
Treat underlying cause
Venous ulcers
Pathophysiology
Venous insufficiency Fluid leaks from veins and capillaries Oedema and deposition of plasma proteins Hypoxia Damage to local tissues Eventually ulceration
Venous ulcers
What does the ulcer look like? - colour, edge
What does the surrounding skin look like? - colour and why
What is lipodermatosclerosis?
Rough edge
Redness
Purple/blue (blood)
Brown (haemosiderin)
Varicose veins
Inflammation of SC fat causing pain and constriction of the soft tissue
Venous ulcers
Management - Wound care and compression therapy
- Debridement
- Dressing
- Compression bandaging to squeeze out fluid over days
- Compression stockings long term
- Elevation
Venous ulcers
Management - further interventions for venous incompetence, eczema and signs of infection
Surgery
Endovenous ablation for superficial venous incompetence
Betnovate
Antibiotics
Arterial Ulcers
Cause
What is it occasionally mixed with?
Risk factors
PVD
Venous ulceration
DM and smoking
Arterial ulcers
What does the ulcer look like? - edge
Where is it usually found?
What does the surrounding skin look like?
What are some other signs you might see?
Punched out appearance - clear edge
Distal pressure points - toes, pad, heels, maelloli
Pale Painful Dry Cool Shiny Hairless
Absent/weak pulse
Signs of infection
