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15 Cards in this Set

  • Front
  • Back
What is a traumatic ulcer?
failure of a lesion to heal, usually due to compromised blood supply and unstable scar
Where are traumatic ulcers usually found?
Bony prominences
How do you treat traumatic ulcers?
usually resection of ulcer
Unstable scar and think skin
Reconstruction with local or distant flap
What is the most common type of ulcer?
Venous
Arterial
Diabetic
Venous - 70%
What are the causes of venous ulceration?
What about arterial?
Venous
Valvular incompetence
Venous hypertension
Arterial
Secondary to small and/or large vessel disease
What do venous ulcers look like compared to artieral?
Diabetic?
venous ulcers
yellow exudates with granulation tissue with irregular wound margins
Arterial ulcers
pale/white, necrotic base +/- dry eschar covering with an even 'punched out' appearance
Diabetic
Necrotic base with irregular or punched out or deep borders
Apart from the ulcer what might a person with venous ulceration also present with?
Dependent oedema (champagne bottle - proximal swelling, distal narrowing)
Trauma
Rapid onset +/- thrombophlebitis
Varicosities
Which type of ulcers are the most painful?
Arterial
NB: more painful with leg elevation and exercise but pain at rest as well
Venous are moderately painful - decreased with elevation, no pain at rest
Diabetic are painless
What is the most common location for venous ulcers compared to arterial?
venous ulcers - medial malleolus
Arterial - distal locations
Where do diabetic ulcers hang out?
pressure point distrubitions
How do you manage venous ulcers?
leg elevation, rest
Compression stockings
Moist would dressings +/- topica, systemic antibiotics +/- skin grafts
How do you manage arterial ulcers?
Rest
No elevation
No compression
Moist wound dressing +/- topical, systemic antibiotics
Modify RF, Rx underlying conditions
Vascular surgical consult
How do you treat diabetic ulcers?
Control diabetes
Foot care
Orthotics
Early intervention fo infections (topical +/- systemic antibiotics)
Vascular surgical consultation
What is critical limb ischaemia characterised by?
ulceration or gangrene of the foot or toes
OR
persistently recurring ischaemic pain at rest requiring analgesia for > 2 weeks
Ankle systolic BP < 50 mmHg
How do you manage critical limb ischaemia?
If they have critical limb ischaemia - i.e. limb viability threatened - active surgical intervention
bypass grafting
endarterectomy
endoluminal techniques
Primary amputation may be the only way to control pain