leg ulcer Flashcards
1
Q
what is a leg ulcer
A
chronic leg ulcer is an open lesion between the knee and ankle joint that remains unhealed for at least 4 weeks
2
Q
what percentage of leg ulcers are venous
A
60-80%
3
Q
where are leg ulcers treated
A
- community
- joint effort community and secondary care
- in patient treatment
4
Q
what is the assessment process for a leg ulcer
A
Identify
- clues to the underlying aetiology
- factors contributing to delayed healing
- SIGN (2010) suggests the use of assessment tool
order of assessment is:
patient, leg, ulcer
5
Q
what are symptoms and signs of vasculitis
A
- painful
- sudden onset
- purpuric rash/pustules
- necrotic
6
Q
what investigations are taken for a pint with a leg ulcer
A
- ABPI (ankle/brachial pressure index)
- Wound swab: only if ulcer is increasingly painful/exudate/malodour/enlarging
- Bloods: FBC, LFTs, U+Es, CRP
- Patch testing: to previous ulcer treatment
- Duplex scan if indicated
7
Q
what is the SIGN guidelines on ABPI (ankle/brachial pressure index)
A
1.0 = normal
0.8-1.3 = compress
<0.8 = vascular disease
>1.5 = calcification
8
Q
how do you treat a venous ulcer
A
- control pain
- ABPI
- non adherant dressing
- de-sloughing agent if necessary eg hydrogel
- 4 layer compression bandaging
- leg elevation
9
Q
what is 4 layer bandaging system
A
- Graduated compression
- 40mmHg at ankle and 25mmHg below knee
- Latex/rubber free if possible
- Applied by a trained nurse
- Non-adherant dressing
- Leg padded to a cone shape
- Changed weekly, or as required
