Varicose Veins and Venous Ulceration Flashcards
What are varicose veins?
- Dilated, tortuous, superficial veins that occur secondary to incompetent venous valves which causes blood to flow backwards
What are the risk factors for varicose veins?
- Increasing age,
- Female gender
- Pregnancy (uterus compresses pelvic veins)
- Obesity
What are the signs and symptoms of varicose veins?
- Visible superficial veins,
- Pain often heavy or cramping,
- Oedema
- Varicose eczema
- Haemosiderin deposits which cause hyperpigmentation
- Lipodermatosclerosis
- Skin discolouration
- Risk of haemorrhage
- Venous ulceration
What are the investigations for varciose veins?
Venous duplex ultrasound - will show retrograde flow
What is the conservative management of varicose veins?
Conservative management - Leg elevation, weight loss, regular exercise, compression stockings.
What are some reasons to refer to secondary care?
- Significant lower limb symptoms such ad pain, discomfort
- Previous bleeding from varicose veins
- Skin changes
- Superficial thrombophlebitis
- Ulcers
What are the management options offered by secondary care for varicose veins?
- Endothermal ablation,
- Foam sclerotherapy
- Sugery
Describe typical features of a venous ulcer?
- Typically located above the medial malleolus.
- Shallow and slought in nature
- Presence of haemosiderin deposition
- Oedema
- Skin thickening
- Eczema
What are the risk factors for venous ulcers?
Obesity,
Immobility
Varicose veins
DVTs
Advancing age
What are the investigations of venous ulcers?
Ankle-brachial pressure index
What is the management for venous ulcers?
- Compression bandaging
- Lifestyle measures
- Oral pentoxifylline
What are the complications of venous ulcers?
Decreased mobility
Risk of infection
Osteomyelitis
Decreased quality of life
What are the signs and symptoms of arterial ulcers?
- Usually occur distally,
- Small and deep
- Punched out margin
- Associated with other features of PAD
