Venous Ulcers Flashcards
Define Venous Ulcers?
Large, shallow, sometimes painful ulcers usually found superior to the medial malleoli
They are cause by incompetent valves in the lower limbs leading to venous stasis and ulceration
What is the aetiology of venous ulcers?
They are caused by incompetent valves in the lower limbs
Valve incompetence leads to venous stasis and increase venous pressure
This results in ulceration
What is the risk factors for Venous Ulcers?
Obesity Immobility Recurrent DVT Varicose Veins Previous injury/surgery to the leg Age
What is the epidemiology of Venous Ulcers?
Very Common
Increases with age
What are the presenting symptoms of Venous Ulcers?
Large , Shallow, Relatively Painless Ulcer with an irregular margin situated above the medial malleoli (most of the time)
What are the features of a history of Venous Ulcers?
Varicose Veins DVT Phlebitis Fracture, trauma or surgery Familiy Histroy Other symptoms of venous insufficiency
What are the other symptoms of Venous Insufficiency?
Itching
Swelling
Aching
What are some other signs of Venous Ulcers?
Stasis Eczema
Lipodermatosclerosis (inverred champagne bottle sign if severe)
Haemosiderin deposition (dark colour)
What do we do with an ABPI for Venous Ulcers?
Exclude arterial ulcer
If ABPI < 0.8 - don’t apply a pressure bandage as this could worsen the ulcer
Why do we measure the surface area of ulcer for Venous Ulcers?
Allows monitoring of progression
When do we do a swab for micrology in the investigation of Venous Ulcers?
If signs of infection
When do we do a Biopsy for investigation of Venous Ulcers?
If possibility of Marjolin’s Ulcer
What is the management plan for Venous Ulcers?
Graduated compression (reduced venous stasis)
Debridement and cleaning
Antibiotics - if infected
Topical Steroids
What must we exclude before doing graduated compression for the management of Venous Ulcers?
Diabetes
Neuropathy
PVD
Why do we prescribe topical steroids for Venous Ulcers management?
May help with surrounding dermatitis
