Leg Ulcers Flashcards
What is chronic leg ulcer?
Open lesion between knee and ankle joint that remains unhealed for at least 4 weeks
Cause of arterial ulcers
Poor blood supply to the skin due to peripheral arterial disease
Cause of venous ulcers
Pooling of blood and waste products in the skin due to venous insufficiency
Feature of arterial ulcers
Absent pulses Pallor Tend to be smaller Deeper Regular border Grey colour Less likely to bleed More painful Pain worse on elevating the leg
Site of arterial ulcers
Distal to ankle
Overlying pressure points
Features of venous ulcers
Oedematous flushed skin Hyperpigmentation Tend to be larger Superficial Irregular border More likely to bleed Varicose eczema Pain relieved by elevation Champagne bottle deformity Hardened skin
Risk factors for arterial ulcers
PVD
Diabetes
Smoking
Risk factors for venous ulcers
Varicose veins
DVT
Phlebitis
Oedema
Why is ABPI done?
To establish if there is arterial disease
ABPI >1.3
Calcification
ABPI 0.8-1.3
No evidence of significant arterial disease
ABPI 0.5-0.8
Suggests presence of arterial disease or mixed arterial/venous disease
ABPI <0.5
Severe arterial disease
When should swabs be done of leg ulcers?
Only if signs of infection or cellulitis
Treatment of arterial ulcers
Good wound care
Treatment of underlying arterial insufficiency
