Venous Ulcers

Question 1

Define Venous ulcers

Answer 1

• large, shallow, sometimes painful ulcers usually found superior to the medial malleoli.

Question 2

what is the aetiology of venous ulcers?

Answer 2

• they are caused by incompetent valves in the lower limbs
• valve incompetence leads to venous stasis and increased venous pressure
• this results in ulceration

Question 3

risk factors for venous ulcers?

Answer 3

o	Recurrent DVT
o	Varicose veins
o	Previous injury/surgery to the leg
o	Obesity
o	Immobility
o	Age

Question 4

epidemiology of venous ulcers?

Answer 4

• common and increases prevalence with age

Question 5

presenting symptoms of venous ulcers?

Answer 5

• Large, shallow, relatively painless ulcer with an irregular margin situated above the medial malleoli
• often following DVT, varicose veins, phlebitis, or injury

Question 6

what are other symptoms of venous insufficiency?

Answer 6

o Swelling
o Itching
o Aching

Question 7

key signs of venous ulcers on examination?

Answer 7

• commonly superior to the medial malleolus
• large and shallow
• often wet
• stasis eczema
• lipodermatosclerosis (upside-down champagne bottle)
• Haemosiderin deposition (dark patches)

Question 8

appropriate investigations for venous ulcers?

Answer 8

• ABPI (this excludes arterial ulcer)
• measure the SA of the ulcer
• do swabs for microbiology
• take a biopsy in case of Marjolins ulcer (malignant)

Question 9

The management plan for venous ulcers?

Answer 9

• graduated compression
• debridement and cleaning
• antibiotics if infected
• topical steroids to help surrounding dermatitis

Question 10

prognosis of venous ulcers?

Answer 10

• good

- better when a patient has fewer comorbidities