VARICOSE ULCERS
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VARICOSE ULCERS

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    VARICOSE ULCERS VARICOSE ULCERS Presentation Transcript

    • VARICOSE ULCERS Venous Ulcers, Stasis Ulcers, Ulcus Cruris A venous leg ulcer is the most common type of leg ulcer, accounting for 80- 85% of all cases. Venous leg ulcers develop when persistently high blood pressure in the veins of the legs (venous hypertension) causes damage to the skin, which eventually breaks down and forms an ulcer.
    • A varicose ulcer is a painful, bloody lesion that appears on the skin when underlying veins are unable to pump blood efficiently. venous valves that exist to prevent backflow of blood do not function properly pressure in veins increase blood is not pumped as effectively into or out of the area and it pools venous hypertension exists arteries no longer have significantly higher pressure than veins blood proteins to leak into the extravascular space, isolate ECM molecules and growth factors, preventing them from helping to heal the wound stretch veins
    • Venous leg ulcers affect around 1 in 500 people in the UK. This rate rises sharply with age with an estimated 1 in 50 people over the age of 80 developing venous leg ulcers. RISK FACTORS: - immobility - obesity -have varicose veins -DVT -diabetes -age -peripheral arterial disease
    • -a chronic non-healing wound with broken skin and exposed tissue. -usually found on the inside of the leg, just above the ankle -painful, particularly when infected -pitting oedema - lipodermatosclerosis - atrophie blanche SYMPTOMS
    • DIAGNOSIS -GP diagnosis based on symptoms and a physical examination (varicose veins - standing up and ulcer - lying down) -Look for symptoms of a venous leg ulcer and feel your pulse at ankles (check arteries) - Doppler study: taking a measurement of blood pressure in each leg, at the ankle, and comparing it with the blood pressure in arm. The arterial blood pressure should be about the same in the arms and legs (differentiate between arterial and venous ulcers – different treatments!) - Colour duplex ultrasound scan: measurement of blood flow in the veins and arteries of the leg so that venous valves can be assessed and arteries checked
    • -70% of small ulcers will heal within 12 weeks. -Larger ulcers may take longer to heal. -Treatment involves cleaning and dressing the wound and using compression bandages to control blood pressure inside the legs. Compression treatment: 70% of ulcers to heal within six months. Ulcer dressings: provide conditions for the ulcer to allow healing. Clean the ulcer (remove debris and dead tissue that accumulates on the surface of the ulcer between dressing changes), use a simple, non-sticky dressing. 4E’s: education, elevation, elastic compression and evaluation. -Active movement -Leg elevation -Emollient use -Treating the underlying condition -Treatment of any infection? TREATMENT
    • Varicose vein surgical treatments e.g.: endovenous ablation, vein ligation/stripping, endoscopic vein surgery, ambulatory phlebectomy, transilluminated powered phlebectomy, subfascial endoscopic perforator surgery, clariVein, endovenous thermal ablation, foam sclerotherapy Artificial skin (collagen and cultured skin cells)
    • COMPLICATIONS: Unless underlying risk factors such as immobility, obesity and varicose veins are addressed, there is a high risk of a venous leg ulcer reoccurring. - loss of mobility - infection (rarely infection could lead to more serious conditions such as osteomyelitis or sepsis) PREVENTION: -wearing a compression stocking - losing weight if you are obese -taking care of your skin.
    • Websites • http://www.oculusis.com/us/dc/varicose/varicose2.php • http://www.bolandcell.co.za/L-MESITRAN_2008.html • http://www.drvaibhavinamdar.com/varicose-ulcer.html • http://www.worldwidewounds.com/1997/september/Thomas-Ban • http://www.tayfungurbuz.com/variscerrahisi_en.asp • http://www.nhs.uk/Conditions/Leg-ulcer-venous/Pages/Diagnosis. • http://en.wikipedia.org/wiki/Venous_ulcer • http://www.wisegeek.com/what-is-a-varicose-ulcer.htm • http://www.rightdiagnosis.com/v/varicose_ulcers/symptoms. htm • http://www.netdoctor.co.uk/surgical-procedures/varicose- ulcer-treatment.htm
    • Websites • http://www.oculusis.com/us/dc/varicose/varicose2.php • http://www.bolandcell.co.za/L-MESITRAN_2008.html • http://www.drvaibhavinamdar.com/varicose-ulcer.html • http://www.worldwidewounds.com/1997/september/Thomas-Ban • http://www.tayfungurbuz.com/variscerrahisi_en.asp • http://www.nhs.uk/Conditions/Leg-ulcer-venous/Pages/Diagnosis. • http://en.wikipedia.org/wiki/Venous_ulcer • http://www.wisegeek.com/what-is-a-varicose-ulcer.htm • http://www.rightdiagnosis.com/v/varicose_ulcers/symptoms. htm • http://www.netdoctor.co.uk/surgical-procedures/varicose- ulcer-treatment.htm