Leg Ulcers

Question 1

define

Answer 1

this is an open lesion between the knee and ankle joint that remains unhealed for at least 4 weeks

Question 2

different types

Answer 2

venous
arterial
RA
diabetic

Question 3

rarer causes

Answer 3

necrobiosis lipoidica (diabetes)
pyoderma gangrenosum (inflammatory pustules that become ulcers)

Question 4

presentation

Answer 4

pain
leakage
smell
infection
slough
lipodermatosclerosis (fat inflammation)
hyperpigmentation

Question 5

what must a leg ulcer be distinguished from?

Answer 5

vasculitis (painful, sudden onset, purpuric rash and necrosis)

Question 6

diagnosis

Answer 6

position of ulcer (medial and lateral malleoli)
ABPI
swabs (infection)
bloods
patch testing for venous eczema
duplex scan

Question 7

management

Answer 7

control pain
clean using warm water and a soap substitute
non-adherent dressing
de-sloughing agent e.g. hydrogel/honey
4 layer compression bandaging
leg elevation and compression

Question 8

describe 4-layer compression bandaging used in leg ulcers

Answer 8

40mmHg at ankle and 25mmHg at knee to facilitate blow flow to the heart
cone shape
changed weekly

Question 9

estimated healing time

Answer 9

12 weeks

Question 10

ways to remove devitalised tissue

Answer 10

• autolytic
• sharps with scalpel or scissors
• biological
• surgical

Question 11

describe autolytic debridement

Answer 11

use of dressing to create moist wound environment and hydrate necrotic tissue

Question 12

describe biological debridement

Answer 12

larvae therapy- maggots