OnlineMedEd: Surgery: General - "Leg Ulcers" Flashcards

1
Q

List the five categories of ulcers.

A
  • Compression
  • Diabetic
  • Arterial insufficiency
  • Venous insufficiency
  • Marjolin
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2
Q

Review the stages of ulcers.

A
  • I: non-blanching erythema
  • II: through the epidermis and into dermis
  • III: through dermis (fascia is visible)
  • IV: bone/muscle exposed
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3
Q

Why do pressure ulcers arise?

A

The skin gets pinched between the bone and whatever the person is sitting on and causes microvascular ischemia.

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4
Q

To prevent pressure ulcers, you need to move the person _____________.

A

Q2H

Air mattresses can help.

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5
Q

Diabetic ulcers are caused by ______________.

A

a mixture of microvascular damage and neuropathy

They can’t sense when they are hurting their feet (like shoes too tight, walking incorrectly, bumping toes and not checking them) and they have a chronic ischemia anyway.

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6
Q

How do you treat diabetic ulcers?

A
  • Control glucose
  • Regular foot checks
  • Elevate legs
  • Diabetic shoes that don’t cause compression
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7
Q

How do you diagnose arterial insufficiency ulcers?

A

•Distal ulcers (tips of toes) with these additional signs:

  • Hairless leg
  • Shiny skin
  • Absent/weak pulses
  • Do an US Doppler to look for decreased arterial flow
  • Do angiography to definitively diagnose and treat
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8
Q

In general, you stent any PVD that is ____________ and bypass ______________.

A

above the knee; below the knee

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9
Q

Those with venous insufficiency will often develop _______________ from deposition of hemosiderin.

A

hyperpigmentation

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10
Q

Venous stasis ulcers commonly present on ________________.

A

the medial malleolus

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11
Q

How do you treat venous stasis ulcers?

A
  • Correct the underlying problem (CHF, volume overload)
  • Diuresis
  • Compression socks
  • Elevated the legs
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12
Q

An ulcer with a sinus tract or one that breaks down and heals repeatedly is likely a ____________.

A

Marjolin ulcer –actually SCC

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