OnlineMedEd: Surgery: General - "Leg Ulcers" Flashcards
List the five categories of ulcers.
- Compression
- Diabetic
- Arterial insufficiency
- Venous insufficiency
- Marjolin
Review the stages of ulcers.
- I: non-blanching erythema
- II: through the epidermis and into dermis
- III: through dermis (fascia is visible)
- IV: bone/muscle exposed
Why do pressure ulcers arise?
The skin gets pinched between the bone and whatever the person is sitting on and causes microvascular ischemia.
To prevent pressure ulcers, you need to move the person _____________.
Q2H
Air mattresses can help.
Diabetic ulcers are caused by ______________.
a mixture of microvascular damage and neuropathy
They can’t sense when they are hurting their feet (like shoes too tight, walking incorrectly, bumping toes and not checking them) and they have a chronic ischemia anyway.
How do you treat diabetic ulcers?
- Control glucose
- Regular foot checks
- Elevate legs
- Diabetic shoes that don’t cause compression
How do you diagnose arterial insufficiency ulcers?
•Distal ulcers (tips of toes) with these additional signs:
- Hairless leg
- Shiny skin
- Absent/weak pulses
- Do an US Doppler to look for decreased arterial flow
- Do angiography to definitively diagnose and treat
In general, you stent any PVD that is ____________ and bypass ______________.
above the knee; below the knee
Those with venous insufficiency will often develop _______________ from deposition of hemosiderin.
hyperpigmentation
Venous stasis ulcers commonly present on ________________.
the medial malleolus
How do you treat venous stasis ulcers?
- Correct the underlying problem (CHF, volume overload)
- Diuresis
- Compression socks
- Elevated the legs
An ulcer with a sinus tract or one that breaks down and heals repeatedly is likely a ____________.
Marjolin ulcer –actually SCC
