Leg Ulcers Flashcards
What is the definition of a CHRONIC leg ulcer?
open lesion between the knee and ankle joint that remains unhealed for at least 4 weeks.
What type of leg ulcer is most common?
60-80% of leg ulcers are venous in nature
What other forms of leg ulcers can be developed by patients?
22% arterial disease
9% rheumatoid arthritis (due to defective neuropathy)
5% diabetic (due to defective neuropathy)
Mixed arterial venous disease 10-20%
The prevalence of leg ulcers increases with age. True/False?
=> will become more of a problem with the ageing population
Who is responsible for treatment of leg ulcers?
> 80% of chronic venous leg ulcers cared for in the community
12% community and secondary care
5% in-patient treatment
What distressing symptoms may leg ulcers cause?
pain leakage smell infection social isolation
How much does it roughly cost the NHS per year to treat 1 leg ulcer?
£1500 per annum to treat 1 leg ulcer
Why do leg ulcers cost so much to treat?
By time patient presents, the degree of disease is extensive:
Delay in full assessment and diagnosis
Delay in ABPI’s or none at all
Delay in commencing compression
Lack of confidence in compression application
Expensive dressings and inappropriate use
What other causes should you consider when examining a leg ulcer?
Venous Arterial (or mixed arterio-venous) Vasculitic Malignant Inflammatory “Hydrostatic” - dependant limb
What is the order of assessment in a patient with a leg ulcer?
What background factors should you consider about the patient before thinking about their leg and ulcer?
Current medication Social circumstances Smoker past or present Mobility Pain Sleep disturbance
What is Lipodermatosclerosis and why is it important in the formation of a leg ulcer?
A sclerotic reaction to venous hypertension:
insufficient blood supply
more likely to form ulcer if trauma occurs
Why does venous dermatitis occur?
the non-nutritious venous blood irritates the skin
What ulcers can be found in the “gaiter area” ?
What type of ulcers are commonly found further up the calf?
Arterial OR Skin cancers
Where can pressure ulcers be found?
On the heels
patients get these if bedbound for significant amount of time
What type of ulcers are common in the foot?
Diabetic due to lack of feeling
What is slough?
skin debris and dead bacteria on top of ulcerated tissue
often yellow in colour
What disease is Necrobiosis Lipoidica linked to?