Leg Ulcer Management Flashcards Preview

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Flashcards in Leg Ulcer Management Deck (58):
1

Compression therapy is the mainstay of venous ulcer treatment.

T

2

Bacterial colonisation of chronic wounds always adversely affects healing.

F

3

Moist wound healing is better than dry wound healing.

T

4

Venous insufficiency is the most common cause of leg ulcers.

T

5

Up to 50% of patients with chronic venous insufficiency have a history of leg injury.

T

6

Venous ulcers that are not complicated by infection typically have minimal exudate.

F Exude copious exudates – yellowish fibrinopurulent, irregularly-shaped adherent exudates may be seen at the base of the ulcer

7

Risk factors for arterial ulcers include diabetes, smoking, hyperlipidaemia, hypertension, obesity and age.

T

8

Venous ulcers will often be associated with hair loss, atrophy, cold surrounding skin, and thickened toenails.

F Arterial ulcers.

9

Capillary refill time in the setting of venous ulcers is usually prolonged.

F Arterial ulcers,

10

Immobility is necessary for pressure ulcer development

T

11

Impaired nutritional states along with low albumin and immobility can lead to epidermal moisture and vapour loss which leads to breakdown of the stratum corneum barrier

T

12

Arterial ulcers are usually located over pressure points, such as the toes and ankles, and are sharply demarcated with little granulation tissue and a punched-out appearance.

T

13

Arterial ulcers often have a necrotic-appearing wound base.

T

14

Arterial ulcers demonstrate the 6 P’s – pulseless, pain, pallor, poikilothermia, punched-out defect, pressure point location

T

15

The most characteristic lesion of the diabetic foot is a mal perforans ulceration.

T

16

Neuropathic ulcers most characteristically develop over the pressure points of the 2nd and 3rd metatarsal heads, and the great toes.

F 1st and 5th metatarsal heads, and great toes.

17

Venous ulcer pain is often described as a burning pain

T

18

Pain is more common with venous disease.

F Arterial disease.

19

Claudication and rest pain are characteristic of arterial ulcers

T

20

An ankle-brachial index (ABI) of 1.5 or higher is normal.

F 1.0 – 1.3

21

ABI of 0.4 or less may indicate severe arterial disease.

T

22

Neuropathic ulcers are typically a punched-out defect with a thick surrounding callus.

T

23

Probing of sinuses and deep ulcers is not a sensitive method for detecting bone infection.

F Is highly sensitive.

24

Care must be taken in using compression in patients with chronic heart failure – compression of the lower extremities can lead to an increase in preload volume and exacerbate their condition.

T

25

The Unna boot is a moist zinc oxide-impregnated paste bandage that hardens to inelasticity.

T

26

Multi-layer compression bandages provide no benefit over single-layer bandage systems.

F Multi-layer are superior.

27

The overall standard composition of multilayer compression bandages is: a wool or cotton layer, one or two elastic wraps, and a self-adherent wrap to hold all the layers in place and to maintain the proper position of the bandage on the leg.

T

28

Multilayer compression provide pressures of 60-80mmHg at the ankle and 30mmHg below the knee.

F 40-45mmHg at the ankle, 17mmHg below knee.

29

Aspirin has been associated with improved healing speed for venous ulcers.

T Via its anti-inflammatory action and its action on haemostatic mechanisms.

30

Pentoxifylline should not be used as an adjuvant to compression therapy.

F Effective adjuvant – 800mg tds.

31

In an acute wound, infection risk is greatest during the first 72-96hours after injury.

F 48-72hrs.

32

Detection of microorganisms from chronic leg wounds typically represents infection.

F Colonisation.

33

Predisposing factors for infection and colonised wound response include advancing age, diabetes, immune compromise, obesity, impaired circulation, malnutrition and remote infection.

T

34

Topical antibiotics should be used for leg ulcers.

F Use is controversial.

35

A moist wound environment induces acute wounds to re-epithelialize up to 40% faster than air-exposed wounds.

T

36

Debridement is the process of removing necrotic, devitalised tissue and foreign matter from a wound.

T

37

Regarding wound dressings for leg ulcers, hydrogels (eg Intrasite) are semitransparent, soothing, and do not adhere to wounds.

T

38

Regarding wound dressings for leg ulcers, alginates (eg. Kaltostat) are not absorbent or haemostatic.

F Are absorbent and haemostatic.

39

Regarding wound dressings for leg ulcers, alginates are best for highly exudative wounds, and partial or full-thickness wounds.

T

40

Regarding wound dressings for leg ulcers, hydrocolloids (eg Duoderm) are transparent, create a bacterial barriers and adhere without a secondary dressing.

F This is true for film dressings (eg Opsite, Tegaderm).

41

Regarding wound dressings for leg ulcers, hydrocolloids are indicated for partial- or full-thickness wounds, and stages 1-4 pressure ulcers.

T

42

Regarding wound dressings for leg ulcers, alginates require a secondary dressing.

T

43

Regarding wound dressings for leg ulcers, foams (eg Allevyn) are absorbent and conform to body contours.

T

44

Large wounds with a great amount of necrotic debris are particularly poor candidates for surgical debridement.

F Good candidates.

45

Surgical debridement is the treatment of choice for fulminant infection.
.

T

46

Mechanical debridement can be performed by applying wet-to-dry dressings, whirlpool baths and high-pressure irrigation

T

47

Wet-to-dry debridement does not affect viable wound tissue.

F Lifts away viable tissue within the wound.

48

Autolytic debridement involves using occlusive and semiocclusive dressings to promote a moist environment to accelerate the autolytic process.

T

49

Dressings suitable for autolytic debridement include hydrocolloids, hydrogels, alginates, and transparent films.

T

50

Autolytic debridement is typically more painful than wet-to-dry debridement.

F

51

Biosurgical debridement involves the application of maggots.

T

52

Enzymatic debridement is slower than autolytic debridement.

F

53

Enzymatic debridement commonly uses topical preparations of collagenase and papainurea.

T

54

The most common cause of graft failure is infection of the ulcer bed.

T

55

Lipodermatosclerosis does not affect ulcer healing.

F Poor prognostic factor.

56

Regarding graft types; epidermal grafts include cultured epidermal autografts and allografts

T

57

Regarding graft types; dermal replacements include integra

T

58

Regarding graft types; composite grafts include apligaf

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