Leg Ulcers Flashcards
What are leg ulcers?
Any break in the skin of the lower leg above the ankle which presents for more than 4 weeks
What is the underlying problem in leg ulcers?
Vascular
Organisms worth treating in ulcers?
- Strep Pyogenes
- S Aureus
- Other B haemolytic streptococci
- Anaroves- esp in diabetic patients
Treatment of leg ulcers?
Record the following details: position of ulcer & measure surface area
-Venous Ulcer
What will a venous ulcer present with?
- Venous ulcers usually form below knee and on inner area of ankle
- Inflammation, swelling, aching, itchy and hard, scabbing or flaking, brown or black skin, discharge
What will an arterial ulcer present with?
Arterial ulcers usually form on outer side of ankle, feet, heels or toes
-Red, yellow or back sores, deep wound, tight hairless skin, leg pain at night, no bleeding, cool to touch, leg reddens when dangled and turns pale when elevated
Investigation for Leg Ulcers?
ABPI= establish if there is any arterial disease
- 1= normal
- 0.8-1.3= Compress
- <0.8= Vascular Disease
- > 1.5= Calcification
Swab only if ulcer is increasingly painful/exudate/malodour/enlarging
Bloods= FBC, LFTs, U&Es & CRP
Treatment of leg ulcers?
Control pain
- Non adherant dressing
- De-sloughing agent if necessary eg hydrogel/honey
- Compression stockings (most patients use class 2)
- 4 layer compression bandaging
- leg elevation
Con of non-adherant dressing?
Does not normally heal wound on it’s own
What is autolytic wound bed preparation?
Use of dressing to create moist environment and hydrate necrotic tissue
What is biological wound bed preparation?
Larvae therapy
What are venous ulcers due to?
Insufficient return of blood back to the heart
What are arterial ulcers due to?
Develop as result of damage to the arteries due to lack of blood flow to tissue
Co-morbidities of ulcers?
Varicose veins
Peripheral arterial disease
Diabetes
What is pyoderma gangreosum?
Painful ulcer related to RA
