Flashcards in Ulcers Deck (56):
What causes venous infufficiency?
incompetent venous valves
What causes incompetent venous valves?
thrombus formation or congenital
What are the risk factors for venous insufficiency?
Which one is more common: venous or arterioal insufficiency?
What is the presentation of venous insufficiency?
What is seen on PE of venous insufficiency?
What are early signs of venous insufficiency?
statis dermatitis, inflammation of skin
What is lipdermatosis also called?
champagne bottle legs
Who gets stasis dermatitis more?
women, increase risk with age
What are signs and symptoms of stasis dermatitis?
Medial ankle involvement and progression to foot &/or calf
What are the treatments for stasis dermatitis?
Control venous insufficiency and edema
Ligation of vessels?
What ABX do you use for stasis derm?
topical for erosions
Oral if cellultis
What steroid do you use for stasis derm?
triamcinolone 0.1% ointment
What is most common of lower extremity ulcers?
What are risk factors for venous ulcers?
Previous Leg injury
Who gets venous ulcers more often?
How do you dx venous ulcers?
Ratio of BP at ankle to arm
Color duplex ultrasonography
Where do you see venous ulcers?
What is the treatment for venous ulcers?
-Caution with arterial insufficiency
---Unna boot: zinc oxide-impregnated, moist bandage that hardens after application
-Intermittent pneumatic compression
Wound vac - negative pressure
Hyperbaric oygen therapy
What are the dressing types for venous ulcers?
Simple nonadherent dressings
What meds can you use for venous ulcer treatment?
?? Oral Zinc
What does pentoxifylline do?
Inhibits platelet aggregation, decreases blood viscosity and improves microcirculation
What is the surgical treatment for venous ulcers?
debridement, grafing, venous insufficiency
What is the treatment for venous insufficiency?
Look at chart in PPT
What is the most common cause of arterial insufficiency?
What are the risk factors for atherosclerosis?
What isi the signs and symptoms of arterial insufficiency?
Progresses to resting pain/night pain
Livedoid vascular pattern
Loss of hair
What are 25% of leg ulcers?
What is the etiology of arterial ulcers?
Sickle cell disease
What is the presentation of arterial ulcers?
painful, punched out, necrotic base, at pressure sites
What are pressure sites that get arterial ulcers?
distal toes, pretibial, supramalleolar - lateral
How do you dx arterial ulcers?
How do you treat arterial ulcerS?
What medications do you use for arterial ulcers?
heparin, warfarin, analgesics
What is the most common cause of neuropathic ulcers?
What is sensory neuropathy caused?
What does motor neuropathy cause?
biomechanical changes leading to increased mechanical stress
What dose autonomic neuropathy cause?
AV shunting causing decreased perfusion
increased dryness and fissuring
What do you get to dx neuropathic ulcers?
Labs: CBC, ESR, CRP
What is the treatment of neuropathic ulcers?
wound care - skin graph
Hyperbaric oxygen tx
What are the surgery tx for neuropathi ulcers?
debridement, revision surgery, vascular reconstruction
What is the medication for neuropathic ulcers?
-Improved blood flow and enhances tissue oxygenation
-Dilation of vascular beds thus decreasing symptoms of intermittent claudication
What are some wound healing agents for neuropathic ulcers?
becaplermin (Regranex) - topical recombinant human PDGF
What are pressure ulcer?
decubitus or bed sores
Where are the common spots of pressure ulcers?
heels, sacrum, ischial tuberosities, lateral> medial malleolus, greater trochanter
What are less common spots of pressure ulcers?
head, back, elbows, shoulders
What is a pressure ulcer?
Compression of bony prominence against external surface
What causes pressure ulcers?
continuous pressure, shearing forces/friction, moisture
What are risk factors for pressure ulcers?
Nursing home resident
What has the highest prevalence of pressure ulcers?
What is the age distribution for pressure ulcers?
3rd decade related to spinal cord
What is the gender relation in pressure ulcers?
younger male predom
older female predom
What is the pressure ulcer presentation?
Good history of the onset of ulcer
Associated medical history
Stage of ulcer
Fever, chills, increased pain
What are diagnostic studies for pressure ulcers?
CBC, CRP, ESR
UA and culture- urinary incontinence
Stool exam- fecal incontinence