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15 Cards in this Set
- Front
- Back
What is a traumatic ulcer?
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failure of a lesion to heal, usually due to compromised blood supply and unstable scar
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Where are traumatic ulcers usually found?
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Bony prominences
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How do you treat traumatic ulcers?
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usually resection of ulcer
Unstable scar and think skin Reconstruction with local or distant flap |
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What is the most common type of ulcer?
Venous Arterial Diabetic |
Venous - 70%
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What are the causes of venous ulceration?
What about arterial? |
Venous
Valvular incompetence Venous hypertension Arterial Secondary to small and/or large vessel disease |
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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 |
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Apart from the ulcer what might a person with venous ulceration also present with?
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Dependent oedema (champagne bottle - proximal swelling, distal narrowing)
Trauma Rapid onset +/- thrombophlebitis Varicosities |
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Which type of ulcers are the most painful?
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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 |
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What is the most common location for venous ulcers compared to arterial?
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venous ulcers - medial malleolus
Arterial - distal locations |
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Where do diabetic ulcers hang out?
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pressure point distrubitions
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How do you manage venous ulcers?
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leg elevation, rest
Compression stockings Moist would dressings +/- topica, systemic antibiotics +/- skin grafts |
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How do you manage arterial ulcers?
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Rest
No elevation No compression Moist wound dressing +/- topical, systemic antibiotics Modify RF, Rx underlying conditions Vascular surgical consult |
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How do you treat diabetic ulcers?
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Control diabetes
Foot care Orthotics Early intervention fo infections (topical +/- systemic antibiotics) Vascular surgical consultation |
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What is critical limb ischaemia characterised by?
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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 |
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How do you manage critical limb ischaemia?
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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 |