FN: Leg ulcers Flashcards Preview

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Flashcards in FN: Leg ulcers Deck (10):
1

Definition

Interruption in the continuity of an epithelial surface

2

Causes

Venous: commonest
Arterial
Neuropathic: EtOH, DM
Traumatic e.g. pressure
Systemic diseasee.g. pyoderma gangrenosum
Neoplastic SCC

3

Venous description

1. Painless, sloping, shallow ulcers
2. Usually on medial malleoulus: :gaiter area"
3. Association with haemosiderin deposition and lipodermatosclerosis
4. RFs: venous insufficiency, varicosities, DVT, obesity

4

Aterial description

hx of vasculopathy and RFs
Painful, deep, punched out lesions
Occur @ pressure points
-heal
- Tips of and between, toes
-metatarsal heads (esp. 5th)

OTher signs oc chronic leg ischaemia

5

Neuropathic

Painless with insensate surrounding skin
Warm foot with good pulses

6

Complications

osteomyeltis
Development of SCC in the ulcer (Majorlins ulcer)

7

Investigatins

BPi of possible
Duplex ultrasonography
Biopsy may be neccessary - look for malignant change: Marjolins ulcer

8

Mx of venous ulcers

Refer to leg ulcer community clinic
Focus on prevention
-graduated compression stockings
- venous surgery

Optimise RFs: nutrition, smoking

9

Specific Rx

Analgesia
Bed rest + elevate leg
4 layer graded compression bandage (if ABPI >0.8)
Pentoxyfylline PO
- raised microcirculatory blood flow
- Improves healing rates

10

Other Mx options (no proven benefit)

Desloughing e.g. larval therapy, hydrogel
Topical antiseptics: iodine, Mauka honey
Split-thickness skin grafting may be considered

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