Leg Ulcers

Question 1

What kind of ulcer do diabetics get?

Answer 1

Arterial

Question 2

What kind of ulcer is more common?

Answer 2

Venous

Question 3

How is a leg ulcer managed?

What kind of ulcer would receive compression therapy?
Why are they used?

Answer 3

1. Debridement
   (swab if signs of infection)
2. Bandage
3. Flucloxacillin

Venous ulcer
Counteracts the force of gravity and aids venous and lympthatic return

Question 4

How do you take ABPI?
(arterial brachial pressure index)

How do you calculate ABPI?

What value means diseased arteries?

Answer 4

Measure brachial pressure
Measure posterior tibial pressure
Use an ultrasound

Highest pressure in foot/highest pressure in arm

<1 - treatement required
0.5-0.8 = moderate arterial disease
<0.5 = severe arterial disease

Question 5

What lower limb pulse should you always be able to feel?

Answer 5

Posterior tibial

Question 6

For each of the following factors compare venous and arterial leg ulcers;

• site
• appearance
• pain
• pain relieved on elevation?

Answer 6

Arterial

• feet (primarly heel and ball)
• punched out lesion
• typically smaller than venous
• skin around will appear cold white or bluish
• painful esp at night
• pain relieved by being lowered

Venous

• below knee (normally inside of ankle)
• surrounded by mottled black/brown staining
• is associated with venous eczema
• not normally painful
• pain relieved on elevation

Question 7

Describe the pathophysiology of a leg ulcer

Answer 7

Starts as a small wound which due to blood insufficiency can’t heal

Gets larger and more difficult to heal

Full thickness skin loss