Lower Leg Ulcers

Question 1

What are some features of venous leg ulcers?

Answer 1

• Oedema
• Brown pigmentation
• Lipodermatosclerosis
• Eczema
• Painless

Question 2

Where do venous leg ulcers typically arise?

Answer 2

Above the ankle

Question 3

How would you manage a venous leg ulcer?

Answer 3

• 4 layer compression bandage (once arterial disease has been excluded)
• Surgery

Question 4

When would skin grafting be considered in venous leg ulcers?

Answer 4

• Failure to heal after 12wks

- >10 cm in diameter

Question 5

What is a marjolin’s ulcer?

Answer 5

Squamous cell carcinoma occurring at sits of chronic inflammation (e.g. burns, osetomyelitis)

Question 6

Where do arterial ulcers tend to develop?

Answer 6

Toes and heel

Question 7

Arterial ulcers are painless: TRUE/FALSE

Answer 7

False

Question 8

Where do neuropathic ulcers commonly occur?

Answer 8

Over plantar surfaces of the metatarsal head and hallux.

Question 9

What is the most common condition which leads to amputation which leads to amputation in diabetic patients?

Answer 9

Neuropathic ulcer

Question 10

How do help prevent neuropathic ulcers?

Answer 10

Cushioned shoes to reduced callous formation.

Question 11

Pyoderma gangrenosum is associated with which 2 conditions?

Answer 11

• IBD

- RA

Question 12

Pyoderma gangrenosum can occur at stoma sites: TRUE/FALSE

Answer 12

True

Question 13

What is ABPI?

Answer 13

Ankle-brachial pressure index; it compares the SBP in the lower leg to that of the arm.

Question 14

ABPI > 1.2

Answer 14

Calcified, stiff arteries; may be due to advanced age or PAD

Question 15

ABPI 0.9 - 1.2

Answer 15

Normal

Question 16

ABPI < 0.9

Answer 16

PAD; if less than < 0.5 then refer urgently

Question 17

At what level of ABPI would compression bandaging be acceptable?

Answer 17

> = 0.8