2: Limb Ulceration and Gangrene Flashcards
(56 cards)
Define an ulcer
Break in skin or mucosa
What is the most common type of ulcer
Venous
What % of ulcers are venous
80
What are the three types of ulcer
Venous
Arterial
Neuropathic
What are the risk factors for arterial ulcers
Smoking HTN DM Age Obesity Physical inactivity FH
What are the risk factors for venous ulcers
Venous insufficiency Severe leg trauma Pregnancy Obesity Age
What are risk factors for neuropathic ulcers
Vitamin B12 deficiency
Diabetes mellitus
How will venous ulcers present clinically
V- SIG:
(Venous):
Shallow
Irregular borders
Granulating borders
Where are venous ulcers most often found
Medial malleolus
Are venous ulcers painful
Yes - pain is often worse towards end of the day
Describe symptoms of venous ulcers
Symptoms often precede the ulcer and include itching and aching
Where are arterial ulcers found
Distal sites - often areas of trauma or pressure areas
How will arterial ulcers present clinically
Deep, Well-defined borders
Are arterial ulcers painful
Yes
Describe symptoms prior to arterial ulcers
History of intermittent claudication
Where are neuropathic ulcers located
Pressure areas
What co-morbidities may someone with neuropathic ulcers have
Diabetes
Peripheral vascular disease
Are neuropathic ulcers painful
No
How are venous ulcers diagnosed
clinically
If a venous ulcer is present what may be used to confirm diagnosis of venous insufficeincy
Duplex US
What are the two most common sites of venous insufficiency
Sapheno-femoral
Sapheno-popliteal
Why may ABPI be performed for venous ulcers
To check for arterial component
If you suspect an ulcer is infected what should be done
Swab and culture
What is done to investigate an arterial ulcer
ABPI
Duplex US and CTA
