ulcer vasc/diabetuc Flashcards
ulcer definition
An ulcer is a discontinuity or break in the epithelial layer of a bodily membrane (that impedes normal function of the affected organ)
Due to microscopic death of tissues
margin
border or transitional zone of skin around ulcer
edge
mode of union between the ulcer skin and normal skin
aetiology of ulcers
Arteritis:
- Temporal cell arteritis/giant cell arteritis
- Polymyalgia rheumatica
- SLE/RA
Trauma
Chronic infection
Neoplastic
Venous
Arterial (atherosclerosis/diabetes)
what is a rodent ulcer
A rodent ulcer is a non-melanoma skin cancer, also known as a basal cell carcinoma.
SUPER stands for
for ulcer classification
Sloped, undermined, punched out, everted, raised
sloped edges found in
venous or healing ulcers
undermined edges found in
TB and pressure sores
punched out edge found in
trophic/arterial, syphilis, leprosy, DM
everted edges
SCC
Raised/rolled edge
BCC
undermined ulcer description
Infection affects subcutaneous tissue more than skin, overhanging skin is thin and friable, reddish-blue
punched out represents
rapid death of cells without any attempt to jeal
medial malleolus ulcer
likely venous, varicose ulcer
Diabetic ulcer features
foot, usually sole, painless due to neuropathy
arterial ulcers location
digits of lower limbs are painful
diabetic foot assessment key point
check underside of shoes and fit of shoe
classic arterial ulcer
tip of toes/dorsum of foot v painful
location of short saphenous varicosity with ulcer
lateral leg
BMT
anti platelet PPI statin
green discharge from a wound think about
pseudomonas
coamoxiclav doesn’t cover
surgeons job with ulcer
control bleeding and remove pus
what to give for pseudomonas
tazocin (piperacillin and tazobactam)
2 Ts
temperature and tenderness
chronic ulcer/non-healing ulcer
ulcers that persist despite medical management >6 weeks
do not proceed towards healing and unresponsive to initial therapy
most common type of ulcer
mixed
in patients with chronic leg ulceration
80% present with chronic venous insufficiency
predisposing factor for venous insufficiency
immobility
for venous ulceration
can be treated with compression bandaging
may be complicated by chronic irritant dermatitis
most common site is great saphenous vein (medial malleolus)
can sometimes progress to black necrotic slough
signs of arterial insufficiency include
shiny thin skin, hair loss
what is telengiectasias
thread like veins less than 1 cm
