Venous ulcer disease Flashcards
What are venous ulcers
Venous ulcers are the common form of skin ulcers. They come about secondary to long standing venous hypertension which leads to incompetence of venous valves.
What are the risk factors
Obesity
Immobility
Varicose veins
Previous DVTs
Age
Previous trauma to the leg
What is the common appearance of venous ulcers
Found over the medial malleolus
Shallow, sloughy ulcers
Haemosiderin deposition of he lower leg
Oedema
Skin thickening
Eczema
Where are venous ulcers usually seen
Venous ulceration is typically seen above the medial malleolus
How to assess non healing ulcers
ankle-brachial pressure index (ABPI) is important in non-healing ulcers to assess for poor arterial flow which could impair healing
What is a normal ABPI
0.9 - 1.2. Values below 0.9 indicate arterial disease.
What does a value of 1.3 and above indicate
values above 1.3 may also indicate arterial disease, in the form of false-negative results secondary to arterial calcification (e.g. In diabetics)
How to manage venous ulcers
compression bandaging, usually four layers (only treatment shown to be of real benefit) and emollient treatment of the leg
What also improves healing rate
oral pentoxifylline, a peripheral vasodilator, improves healing rate
What lifestyle advice to give
Keep ulcer clean
encourage mobility
weight reduction
lag elevation at rest
What lifestyle advice to give
Keep ulcer clean
encourage mobility
weight reduction
lag elevation at rest
