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Flashcards in Leg ulcers Deck (28):
1

What is a leg ulcer?

A break in the skin of the lower leg above the ankle that has been present for more than 4 weeks

2

What types of leg ulcer are there?

Venous
Arterial
Mixed
Rheumatoid arthritis associated
Diabetic
Vasculitic
Malignant
Hydrostatic

3

What is the relationship between leg ulcers and age?

Leg ulcers increase with age

4

Who treats most leg ulcers?

Community care

5

Which type of young patients get leg ulcers?

IV drug users
Diabetics

6

What type of morbidity does leg ulcers cause?

Pain
Sepsis
Odour
Exudaye

7

What are important history questions to ask about a leg ulcer?

Duration/first ulcer
Pain
Mobility
Sleep disturbance

8

What are relevant aspects of a medical history in a patient with a leg ulcer?

Peripheral vascular disease
Diabetic
DVT
Clotting disorders
Arterial disease
Varicose veins

9

How should an ulcer be assessed?

Position of ulcer
Measurement of ulcer size

10

What type of ulcer will have haemosiderin staining? Why is this?

Venous
Red blood cells forced out of capillaries

11

What are the features of a venous ulcer?

Shallow edge/border
Lipodermatosclerosis
Hyperpigmentation
Gaitor area (malleolus)
Slough

12

What is slough? What does it indicate?

Dead tissue and debris
Ulceration (NOT infection)

13

How can suspected vascular disease be investigated? What categories can the results be divided into?

Ankle brachial blood pressure index (ABPI)
0.8-1.3 - normal
0.81.3 - calcification

14

How can an ulcer be investigated? Why is each useful?

ABPI - differentiates between arterial and venous
Wound swab - test for infection
Bloods - FBC, LFT, U&E, CRP
Patch testing - test for allergy to ulcer treatments
Duplex if clinical suspicion

15

When should an ulcer swab be taken?

When there are signs of infection - increasing redness, swelling, heat, pain, etc

16

How should a venous ulcer be treated?

Analgesia
ABPI
Non-adherent dressing
De-sloughing (hydrogel, honey)
4 layer compression bandaging
Leg elevation

17

Why might you have to be careful with 4 layer compression bandaging?

Painful legs will need gradual compression

18

How often should compression bandaging be changed?

Weekly
As required

19

How soon should ulcers heal with compression bandaging?

Within 12 weeks

20

Do dressings heal leg ulcers?

No it's whats added to them
Absorbants - aquacel (hydrocollid)
Antibacterial - silver/iodine, manuka honey

21

Most leg ulcers reoccur without prevention. T/F

True

22

What skin conditions are associated with venous leg ulcers?

Venous dermatitis
Atrophie blanche

23

What is atrophie blanche?

Scarring resulting from skin injury where the blood supply is poor (e.g post venous ulcer)

24

Where do vascular and/or diabetic ulcers typically arise?

Where there is most pressure (i.e heals and toes)

25

What is the typical features of an arterial ulcer?

Punched out

26

Ulcers can undergo malignant transformation. T/F

True - but cancer can also present as a non-healing ulcer

27

How are infected ulcers cleaned?

Water and soap substitute

28

Can maggots be used in ulcer care?

Yes

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