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Vascular surgery - Phase II > Vascular ulcers > Flashcards

Flashcards in Vascular ulcers Deck (10)
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1
Q

Define ulcer

A

Interruption in the continuity of an epithelial surface

2
Q

What are the causes of ulcers?

A
Venous - most common
Arterial
Neuropathic - Alcoholics, DM
Trauma - Pressure
Systemic disease e.g. pyoderma gangrenosum 
Neoplasia - SCC
3
Q

What are the properties of a venous ulcer?

A

Shallow sloping sides
Painless
Usually medial gaiter region

4
Q

What are the risk factors for a venous ulcer?

A

Venous insufficiency
Varicosities
DVT
Obesity

5
Q

What are the properties of an arterial ulcer?

A

Punched out, deep lesion
Painful
Appears at pressure points eg heads of metatarsals, heal

6
Q

What are the properties of a neuropathic ulcer?

A

Painless with loss of sensation in surrounding skin
Warm foot
Good pulses
Tend to be on the base of the foot

7
Q

What are some of the complications of an ulcer?

A

Osteomyelitis

Development of SCC in the ulcer

8
Q

What investigations can be done in a patient with an ulcer?

A

ABPI - Ankle brachial pulse index (Less than 0.5 suggests arterial ulcers)
Duplex ultrasonography
Biopsy if concerned about SCC

9
Q

What is the management of venous ulcers?

A

Refer to community ulcer team
Focus on prevention - pressure stockings, venous surgery
Optomise RFs eg smoking, nutrition
Analgesia
Bed rest/leg elevation
4 layer graded compression bandage if ABPI >0.8

10
Q

Define mixed ulcer

A

An ulcer which has developed in a patient with venous and arterial pathology
Use ABPI to determine management