Flashcards in Leg ulcers Deck (28):
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
What types of leg ulcer are there?
Rheumatoid arthritis associated
What is the relationship between leg ulcers and age?
Leg ulcers increase with age
Who treats most leg ulcers?
Which type of young patients get leg ulcers?
IV drug users
What type of morbidity does leg ulcers cause?
What are important history questions to ask about a leg ulcer?
What are relevant aspects of a medical history in a patient with a leg ulcer?
Peripheral vascular disease
How should an ulcer be assessed?
Position of ulcer
Measurement of ulcer size
What type of ulcer will have haemosiderin staining? Why is this?
Red blood cells forced out of capillaries
What are the features of a venous ulcer?
Gaitor area (malleolus)
What is slough? What does it indicate?
Dead tissue and debris
Ulceration (NOT infection)
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
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
When should an ulcer swab be taken?
When there are signs of infection - increasing redness, swelling, heat, pain, etc
How should a venous ulcer be treated?
De-sloughing (hydrogel, honey)
4 layer compression bandaging
Why might you have to be careful with 4 layer compression bandaging?
Painful legs will need gradual compression
How often should compression bandaging be changed?
How soon should ulcers heal with compression bandaging?
Within 12 weeks
Do dressings heal leg ulcers?
No it's whats added to them
Absorbants - aquacel (hydrocollid)
Antibacterial - silver/iodine, manuka honey
Most leg ulcers reoccur without prevention. T/F
What skin conditions are associated with venous leg ulcers?
What is atrophie blanche?
Scarring resulting from skin injury where the blood supply is poor (e.g post venous ulcer)
Where do vascular and/or diabetic ulcers typically arise?
Where there is most pressure (i.e heals and toes)
What is the typical features of an arterial ulcer?
Ulcers can undergo malignant transformation. T/F
True - but cancer can also present as a non-healing ulcer
How are infected ulcers cleaned?
Water and soap substitute