Venous Ulcers Flashcards Preview

Year 5 Cardiology > Venous Ulcers > Flashcards

Flashcards in Venous Ulcers Deck (15)
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1
Q

def

A

ulceration of lower limb by venous insufficiency

80% of leg ulcers

2
Q

what % of ulcers in the legs are venous and arterial

A

venous 80%

arterial 20%

3
Q

aetiology

A

venous HTN results in increased hydrostatic pressure, tissue oedema, impaired microcirculation which leads to tissue necrosis + ulceration

4
Q

epi

A

increases with age

female>male

5
Q

history

A

chronic venous insufficiency can result in
1 leg aching
2 ankle swelling
3 itching

6
Q

examination

A

1 ‘gaiter area’ above medial malleolus is classic position of venous ulcer
2 ulceration is shallow, sloping edges, lipodermatosclerosis
3 examine for varicose veins with patient standing

7
Q

what is lipodermatosclerosis

A

skin changes in the leg with venous insufficiency

  • pigmentation
  • inflammation
8
Q

why should ankle-brachial pressure index be determined

A

to look for peripheral arterial disease

9
Q

what are the DDx for venous ulcers

A

1 arterial ulcers

2 diabetic ulcers

10
Q

investigations

A
1 ankle-brachial pressure index
-for peripheral arterial disease
-<0.5 should be managed for arterial insufficiency in the first instance
2 microbiology swab
-with signs of infection
3 biopsy
-exclude malignancy
11
Q

management

A

1 multi-component compression bandaging
-correct venous HTN with Charing Cross four layer bandage
-leg elevation
-compression stockings to prevent recurrence
-antibiotics for infection
2 surgery
-treat varicose veins

12
Q

what is the charing cross four layer bandage

A
bandage used to correct venous HTN in venous ulceration
1 wool
2 crepe
3 elastic
4 cohesive bandages
13
Q

complications

A

1 chronic wounds
2 infection
3
recurrence

14
Q

what is marjolins ulcer

A

complication of chronic venous ulcers

malignancy in long-standing ulcer

15
Q

prognosis

A

high recurrrence rates (25% at one year)