Wound management Association Ireland 2011
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The document discusses various topics related to chronic wounds including: 1) Surgical interventions and trials showing benefits of compression therapy and surgery for venous disease. 2) Factors that can cause ulcers like venous disease, arterial disease, diabetes, and infection. Tests to assess these factors are discussed. 3) Treatments addressed include compression therapy, antibiotics, wound dressings, biopsy, excision and grafting, and surgery for venous and arterial issues.
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Cancers hépatiques métastatiques : Actualité 2013-2014
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This document discusses lymphedema, including its classification, diagnosis, assessment, grading, and treatment options. It classifies lymphedema as primary or secondary and notes the prevalence among vascular clinic patients. Treatment options discussed include skin care, compression garments, manual lymphatic drainage, multilayer bandaging, pneumatic compression devices, drug therapy, laser therapy, and surgical options like liposuction and lymphatic reconstruction. Integrated multidisciplinary care is emphasized as most effective for managing this chronic condition long-term.
Beyond consent
1) The document discusses the evolving standards for informed consent in medical procedures, moving from a professional standards approach to a reasonable patient standard that requires disclosure of all material risks.
2) Ensuring patient understanding of medical procedures and risks is challenging, as multiple factors like timing, education level, and context can influence comprehension.
3) Effective consent requires an ongoing process of discussion tailored to individual patient needs that incorporates written information, multimedia tools, and shared decision making to build trust and understanding.
Challenges in the diabetic foot 2016
This document discusses the challenges in treating diabetic foot problems. It notes that neuropathy, deformity, trauma, ulceration, infection, ischemia and limb loss are common complications. A thorough assessment is needed to determine if the foot problem is neuropathic, ischemic, involves osteomyelitis, Charcot neuroarthropathy or a combination. Treatment depends on the underlying issues but may include offloading, antibiotics, debridement, revascularization procedures like angioplasty or bypass. Multidisciplinary care with specialists like vascular surgeons is important for managing the complex challenges of the diabetic foot.
Introduction to vascular surgery
This document provides an overview of topics that will be covered in a vascular surgery lecture series. It discusses various vascular conditions including occlusive arterial disease, aortic aneurysms, carotid disease, varicose veins, occlusive venous disease, lymphedema, visceral arterial occlusion, peripheral aneurysms, arterial trauma, diabetic foot disease, and hyperhidrosis. The lectures will cover the history, physical exam, differential diagnosis, and presentation of these conditions. Specific topics to be addressed include leg ulcers, peripheral arterial occlusive disease, aortic aneurysms, carotid disease, varicose veins, and the diabetic foot. The lectures will also discuss clinical skills for vascular surgeons such as history taking, physical examination, differential diagnosis
Vascular emergencies tcd sjh 2017
This document discusses the presentation, diagnosis, and treatment of vascular emergencies. It notes that abdominal aortic aneurysm, ischemia due to occlusion or embolism, and arterial trauma are common vascular emergencies. Imaging and consultation with vascular surgery is recommended to determine if the patient requires open surgery, endovascular aneurysm repair (EVAR), or other procedures. Immediate transfer to the operating theater is important for ruptured aneurysms to increase chances of survival. Both open surgical repair and newer endovascular techniques are covered.
Faculty of radiologists 2015
The document describes a new surgical training pathway that aims to address issues with the traditional model. The key aspects of the new pathway include:
1) Earlier and more standardized selection of trainees based on multiple criteria including aptitude tests, interviews, and past performance.
2) Structured progression of trainees based on ongoing competency-based assessments rather than time served. Assessments include online evaluations, logbooks, exams, and skills assessments.
3) Matching of trainees to specialized surgical programs in the second year based on performance and preference. This aims to provide more certainty around specialty choices earlier in training.
Rcsi global surgery (final)
The document discusses COSECSA's efforts to address the shortage of surgeons in East, Central and Southern Africa. It notes that over 5 billion people lack access to safe and affordable surgery. COSECSA has worked to enhance surgical training programs, increase the number of examinations, and build infrastructure like the East and Central African Journal of Surgery. Through partnerships with organizations like RCSI, it has helped train over 1,600 surgeons who have an 84% retention rate in Africa. COSECSA aims to continue developing sustainable indigenous training initiatives to address the large unmet need for surgical services in the region.
Tierney communication 2011
Effective communication skills are essential for high quality medical practice. Communication skills should be assessed separately from clinical skills as they require a structured approach distinct from a busy clinical agenda. Communication skills can be assessed using simulated patient encounters, with a focus on information gathering, explanation and relationship building. The Calgary-Cambridge model provides a framework for teaching and assessing key components of the medical consultation.
Professor Tim O'Brien, Director of REMEDI (Regenerative Medicine Institute
Professor Timothy O'Brien discusses several themes in the document. He argues that Ireland working together as a single entity can have global impact in clinical translation, especially in medical device technology and regenerative medicine. He emphasizes that the needs of patients always come first and that Irish healthcare must contribute to economic recovery through innovation, job creation, and industry engagement. O'Brien also discusses the work done at NUI Galway in areas like regenerative medicine, stem cell research, and clinical research facilities. He advocates for Ireland presenting itself as a single entity for clinical research to attract industry partnerships.
Diabetic Foot 2016
This document discusses diabetic foot management and prevention. It covers neuropathy, vascular disease, infection risk and treatment options. Sensory testing like monofilaments can identify high-risk patients. Imaging and tests like ABI, toe pressures and oximetry evaluate vascular status. A multidisciplinary approach is needed to address structural, neurological and vascular issues. Treatment may include offloading, wound care, antibiotics, revascularization or amputation depending on the specific patient presentation and risk factors.
Approach to leg ulcers
The document discusses leg ulcers, their causes, and vascular assessment. The major causes of leg ulcers are venous disease (81%), arterial disease (10%), mixed arterial and venous disease (7%), diabetic neuropathy (1%), and malignancy (1%). Venous ulcers are typically recurrent and painless, showing signs of venous hypertension like haemosiderin and lipodermatosclerosis. Arterial ulcers present with a history of claudication and reduced ABIs. Treatment involves compression therapy for venous ulcers and vascular surgery for arterial insufficiency or venous reflux. Differential diagnosis of leg ulcers considers etiology like vasculitis, neuropathy, or infection.
Vascular trauma
1. The document discusses various types of vascular injuries including sharp, blunt, transection, laceration, and contusion injuries.
2. Signs of vascular injury in the extremities include pain, pallor, pulselessness, perishing cold, paresthesia, paralysis and the "P's". Complications can include bleeding, ischemia, and complications from vascular injury.
3. Evaluation of vascular injuries involves assessment of signs like hard or soft pulses, Doppler, CT angiography, and possible urgent exploration and repair in cases of threatened limbs with paresthesia and paresis.
Vascular techniques
This document provides instructions for various vascular anastomosis techniques:
1) It describes basic principles such as minimal incisions, careful tissue handling, and proximal and distal vessel control.
2) Transverse arteriotomy and embolectomy are explained, involving making an incision, inserting a stay suture, and closing with interrupted sutures.
3) Longitudinal arteriotomy and patch closure involves using a vein patch graft sutured with an everting technique or wrapped around the vessel edge.
4) End-to-end and end-to-side anastomoses are demonstrated, with placement of pursestring or spatulated sutures to approximate the vessels.
Peripheral Vascular Injuries
This document discusses peripheral vascular injuries. Some key points:
- Peripheral injuries account for 80% of vascular trauma cases, with the lower extremities most commonly involved.
- Combined arterial and skeletal injuries in the extremities significantly increase the risk of limb loss compared to isolated injuries.
- Diagnosing and managing vascular injuries is technically challenging, as the physiology of trauma patients is complex. Damage control techniques like shunting and ligation may be necessary.
- Hard signs of vascular injury include active bleeding, pulsatile hematoma, limb ischemia. Soft signs require further investigation like Doppler or angiography to diagnose injury.
- Surgical management involves gaining proximal and distal control, investigating the injury site, and
Arterial trauma
This document discusses extremity vascular injuries, which can result in limb loss or death if not properly treated. The most common causes are road traffic injuries. Clinical features include signs of active bleeding, ischemia, pain, pallor, and pulse absence. Imaging like duplex scans and angiography can help diagnose the injury. Early surgical repair of damaged blood vessels is needed to restore blood flow. Complications include compartment syndrome, which requires fasciotomy to reduce pressure. Close monitoring is also needed after reperfusion to watch for systemic effects. With proper emergency treatment and surgery, many extremities can be saved from amputation.
Abdominal vascular injuries
A lecture about the management approaches for abdominal vascular injuries. Injury to the major arteries and veins in the abdomen are technical challenge to the surgeon and are often fatal. All vessels are susceptible to injury with penetrating trauma. Vascular injuries in blunt trauma are far less common and usually involve the renal arteries and veins, though all other vessels, including the aorta, can be injured. Blunt trauma results from deceleration, AP compression or pelvic fractures.
extremity Vascular trauma / injury
extremity vascular injury, arterial injury, causes of arterial injury, mechanisms of arterial injury, investigations for arterial injury, treatment of arterial injury, , extremity vascular injuryfor medical students
Vascular trauma
This document summarizes the assessment and treatment of vascular trauma. It discusses the history of vascular surgery, mechanisms of injury, initial assessment and treatment focusing on controlling bleeding and ischemia. Signs of arterial injury are outlined. Surgical management may involve angiography, open exploration, repair, bypass or ligation. Compartment syndrome is a risk and location of injury impacts outcomes. Treatment of venous and carotid trauma is also addressed.
Arterial ulcers by joel arudchelvam
This document discusses wound healing and the treatment of chronic ulcers. It covers the following key points:
1. Wound healing occurs in four stages: haemostasis, inflammation, proliferation, and remodeling. Chronic ulcers fail to heal due to prolonged inflammation.
2. Common causes of non-healing ulcers include local infection or trauma, venous or arterial insufficiency, and systemic factors like diabetes or malnutrition.
3. Treatment involves correcting underlying causes, wound cleaning and dressings, and revascularization for arterial ulcers using techniques like bypass surgery, angioplasty, or stenting to improve blood flow.
Venous ulceers
Venous ulcers account for nearly 80% of lower extremity ulcers and are caused by venous hypertension and reflux which damages the veins and capillaries. Risk factors include advancing age, family history, prolonged standing, obesity, smoking, and prior venous thrombosis. Conservative management involves compression therapy, elevation, exercise, and dressings. For severe or non-healing ulcers, surgical options like vein stripping or valvuloplasty may be used to correct venous reflux and lower pressure. Skin grafting can then promote wound closure.
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Clinical Outcomes Of Complicated Diverticulitis Managed Nonoperatively
This study examined clinical outcomes of patients with complicated diverticulitis managed nonoperatively. The researchers reviewed 256 patients diagnosed with complicated diverticulitis via CT scan over a 14-year period. 99 patients were initially managed nonoperatively with antibiotics and some receiving percutaneous drainage. These patients had a high rate of recurrence (46.4%) but a low risk of requiring emergency surgery. The risk of recurrence did not differ significantly between younger (<50 years) and older patients. While recurrence rates were high, the risk of complications requiring emergency surgery was low for patients managed nonoperatively initially. Patient factors, comorbidities, and preferences should all be considered when determining treatment for complicated diverticulitis.
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Early ca esophagus
Early esophageal cancer refers to Tis, T1a, and T1b lesions. The main treatment options are esophagectomy and endoscopic resection. Esophagectomy provides accurate staging but higher morbidity and mortality, while endoscopic resection has lower risk but requires close surveillance. The choice depends on risk factors for lymph node metastasis like depth of invasion, lymphovascular invasion, and tumor size. Minimally invasive esophagectomy techniques aim to reduce complications while achieving equivalent oncologic outcomes.
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Discuss about surgical principles, techniques and evidences regarding surgical treatment options for esophageal and gastric cancer
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Thrombo-prophylaxis used in critically ill patients who are either bleeding or are at high risk for bleeding. This presentationby Dr. Aditya Jindal on "Thrombo-prophylaxis in Critical Care". For more information, please contact: 9779030507.
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Deep vein thrombosis (DVT) is a blood clot that forms in the deep veins, usually of the legs. Virchow's triad describes the three main factors that contribute to DVT formation: venous stasis, hypercoagulability, and endothelial injury. Clinical signs of DVT include calf pain, swelling, and tenderness. Diagnosis involves a clinical prediction model like the Wells criteria along with D-dimer testing and ultrasound imaging. Treatment consists of anticoagulation with heparin or warfarin to prevent pulmonary embolism and further complications.
When to implant a caval filter?
The document discusses the use of vena cava filters, including both permanent and retrievable filters. It notes that while filters can reduce the risk of pulmonary embolism, they also increase the risk of deep vein thrombosis. Two randomized control trials on filters had conflicting results, with one showing a reduction in PE but no effect on mortality, and the other lacking statistical power over shorter periods. More research is still needed to properly assess the safety and effectiveness of filters. The document also discusses newer filter designs and the need for additional randomized trials to help guide clinical decisions around their use.
Deep vein thrombosis
Venous thromboembolism (VTE) refers to deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT occurs when a blood clot forms in a deep vein, usually in the legs, and PE occurs when part of the clot breaks off and lodges in the lungs. Risk factors for VTE include older age, surgery, trauma, cancer, and prolonged immobility. Diagnosis involves blood tests like D-dimer and imaging tests like ultrasound, CT, or venography. Treatment consists of blood thinners like heparin or low molecular weight heparins to prevent clot growth and embolism while allowing the body to naturally break down the clots.
Lower Gastrointestinal Bleed
This document discusses lower gastrointestinal (GI) bleeding, including:
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- Evaluation involves history, physical exam, labs, and endoscopic procedures like colonoscopy to identify the bleeding source and provide treatment.
- Colonoscopy is the gold standard for diagnosis and treatment but must be performed carefully in unstable patients. Angiography and nuclear scans can help localize bleeding in severe cases.
Open Journal of Surgery
Simple liver cysts are congenital or acquired benign cysts formations and are commonly found incidentally. It has a prevalence of 3-5% in ultrasound studies and 18-24% in CT scans. Frequently asymptomatic, liver cysts may be associated with symptoms in 10-16% of patients. Hemoperitoneum is a far rare complication. Herein, we report a case presented at the emergency room with acute hemorrhagic rupture of a liver cyst.
acute upper gi bleeding approch and managment
This document discusses upper gastrointestinal bleeding, including its definition, causes, and management. The causes are categorized as nonvariceal bleeding (80% of cases, most commonly from peptic ulcer disease) or bleeding related to portal hypertension (20% of cases, usually from gastroesophageal varices). Early endoscopy within 24 hours is recommended to identify the source of bleeding and guide treatment. Treatment depends on the specific cause but may include endoscopic therapies like epinephrine injection or thermal coagulation, as well as medications like PPIs. Surgery is considered if endoscopic treatment fails or for high risk lesions.
Dvt
DVT refers to deep vein thrombosis, which is the formation of a blood clot in the deep veins, usually of the legs. Risk factors include age, immobilization, pregnancy, surgery, cancer and genetic factors. Symptoms include leg swelling, pain, redness and tenderness. Diagnosis involves a clinical probability assessment, D-dimer testing and duplex ultrasonography. Treatment includes anticoagulation medications and compression stockings to prevent complications like pulmonary embolism and post-thrombotic syndrome.
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Controversies in diverticular disease and diverticulitis conference presentation
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This document discusses several controversies and areas of ongoing debate in the treatment of diverticular disease. It summarizes recent evidence questioning traditional practices like routine antibiotics for uncomplicated diverticulitis, prophylactic resection after a single attack, and the natural history assumptions of disease progression. The role of laparoscopic versus open surgery and conservative management of complicated diverticulitis are also addressed. Overall, the treatment paradigm is shifting to a more conservative approach with many prior standards now being re-examined based on emerging evidence.Deep venous thrombosis seminar
1) Deep vein thrombosis is a blood clot that forms in the deep veins, usually of the legs. It can break off and travel to the lungs, blocking blood flow (pulmonary embolism).
2) Risk factors include prolonged bed rest, surgery, cancer, and inherited or acquired hypercoagulable states. Symptoms include leg pain, swelling, warmth, and redness. Diagnosis involves a clinical evaluation along with D-dimer testing and ultrasound imaging of the legs.
3) Treatment focuses on blood thinners to prevent clot growth and reduce the risk of embolism. Left untreated, a DVT can lead to long-term leg damage or potentially fatal blockages in
Lower gi bleed
Lower gastrointestinal bleeding can have various causes like diverticulosis, angiodysplasia, inflammation, and cancers. A thorough history, physical exam, and initial tests like colonoscopy are important to determine the source and severity of bleeding. Colonoscopy allows for both diagnosis and potential treatment but often requires bowel prep, while angiography and CT angiography can localize active bleeding but lack therapeutic options. Together, these diagnostic tests aim to safely identify the cause and guide appropriate clinical management of lower GI bleeding.
Iliofemoral DVT thrombolysis
This document discusses current methods for treating deep vein thrombosis (DVT) and the impact of post-thrombotic syndrome (PTS). It provides statistics on the prevalence and costs of DVT and PTS in the US. The document reviews changes to DVT treatment guidelines supporting early thrombus removal through pharmacomechanical thrombolysis. Clinical studies demonstrate pharmacomechanical thrombolysis improves outcomes over anticoagulation alone by increasing patency and reducing long-term PTS symptoms. The document concludes that early thrombus removal through pharmacomechanical techniques is the new standard of care for proximal DVT due to decreased complications and improved patient outcomes compared to anticoagulation or catheter-directed thrombolysis alone.
Splenomegaly as A Complication Factor in Laparoscopic Splenectomy: Outcomes f...
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More from AMNCH Vascular Surgery
Establishing a Foot protection Clinic
This document summarizes the work of Sean Tierney and the Diabetic Foot Protection Service at Tallaght Hospital in Dublin, Ireland. The service was established in the 1990s to address the high rates of lower limb amputation among diabetic patients through a multidisciplinary team approach. The team includes vascular surgery, orthotics, nursing, podiatry and other specialties. Through risk assessment, imaging, offloading, infection treatment and revascularization procedures when needed, the service aims to heal foot ulcers and prevent amputation. Outcomes data shows reductions in amputation rates and hospital bed days used since establishing the coordinated care model.
Peripheral vascular disease 2015
This document discusses peripheral arterial occlusive disease (PAOD), including its presentation and differential diagnosis, assessment and management of cardiovascular risk, and methods for managing symptoms and preventing limb loss. It addresses PAOD as a predictor of cardiovascular disease and its real risks, such as limitation on exercise quality of life, risk of limb loss, and increased global health risk. The document outlines treatments for PAOD that can reduce global risk, provide symptom relief, and treat symptoms, including exercise, drug therapy, endovascular procedures, open surgery, and techniques for limb salvage.
Acute limb ischaemia
An acutely ischemic limb requires prompt assessment and treatment to determine the appropriate revascularization procedure. The vascular surgeon must have a high level of knowledge, judgment, technical skills, and operative experience. Human factors like communication, leadership, and decision making are also critical for successfully treating this emergency condition.
Abdominal Aortic Aneurysm 2015
The document discusses various issues in abdominal aortic aneurysm (AAA) management, including screening, surveillance, predicting operative risk, and choosing between open repair and endovascular aneurysm repair (EVAR). It provides details on screening criteria in different countries, predictors of mortality for open repair, outcomes from EVAR clinical trials showing lower reintervention rates compared to open repair, and types of endoleaks after EVAR. The document also describes fenestrated and branched endografts for more complex aneurysm anatomies and notes there are still unresolved issues regarding EVAR indications.
Diabetic foot 2015
The document discusses diabetic foot disease and prevention. It notes that diabetic foot ulcers and amputations pose a major global health burden. Effective prevention requires risk assessment of patients' structural foot issues, sensation, and vascular status. Those at highest risk require regular screening, education on foot care, and customized treatment like offloading or revascularization depending on their specific issues. Ongoing management may involve wound care, infection treatment, or novel vascular interventions to help avoid amputation.
Carotid surgery 2014
The document discusses the case of a 62-year-old man who experienced a transient ischemic attack. It summarizes the diagnostic workup, including imaging and vascular testing, to determine if the patient had a stroke and the location of any blockages. The document then reviews the evidence and guidelines for treatment of carotid artery disease, including whether the patient is a surgical candidate. Overall, the key information provided is on evaluating and treating patients who experience transient ischemic attacks or minor strokes due to carotid artery disease.
Venous issues 2014
The document discusses various issues related to venous disease including varicose veins, chronic venous hypertension, and leg ulcers. It summarizes guidelines for referring patients for treatment of varicose veins as well as results from the Edinburgh Vein Study. The document also discusses how varicose veins negatively impact quality of life and how surgical treatment can improve quality of life. Treatment options for varicose veins, superficial thrombophlebitis, and venous ulcers are presented.
Pcs sligo 2013
This document outlines the requirements and guidelines for the Professional Competence Scheme operated by the Royal College of Surgeons in Ireland (RCSI). Surgeons must complete a minimum of 50 credits each year from activities in several categories: external activities (20 credits), internal activities (20 credits), personal learning (5 credits), research and teaching (2 credits), and one audit (12 credits). Credits are earned by participating in various professional development and quality improvement activities. Surgeons record their activities and hours in an online portal, and may be audited to ensure compliance with the scheme's requirements.
Introduction
This document provides an overview of topics that will be covered in a vascular surgery lecture series. It discusses various vascular conditions including occlusive arterial disease, aortic aneurysms, carotid disease, varicose veins, occlusive venous disease, lymphedema, visceral arterial occlusion, peripheral aneurysms, arterial trauma, diabetic foot disease, and hyperhidrosis. The lectures will cover the history, physical exam, differential diagnosis, and presentation of these conditions. Specific topics to be addressed include leg ulcers, peripheral arterial occlusive disease, aortic aneurysms, carotid disease, varicose veins, and the diabetic foot. The lectures will also discuss clinical skills for vascular surgeons such as history taking, physical examination, differential diagnosis
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Wound management Association Ireland 2011
- 1. Sean Tierney - RCSI & AMNCH, Tallaght, Dublin WMAI, Galway, October 2011 Surgical interventions in Chronic Wounds
- 2. Problem
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- 4. Limerick trial O'Brien et al Br J Surg 2003
- 5. Limerick trial - cost O'Brien et al Br J Surg 2003
- 6. Topical preparations http://www2.cochrane.org/reviews/en/ab001103.html Last assessed as up-to-date: October 14. 2008
- 10. Role of Surgery * Gohel et al. British Journal of Surgery 2005; 92: 291–297 Healing Recurrence
- 11. Role of surgery Superficial venous disease
- 19. Role of surgery Treat arterial disease Superficial venous disease
- 20. Diabetes ESCHAR Lancet 2004
- 23. Infection Inconclusive Last assessed as up-to-date: November 4. 2009
- 26. Risk of malignancy D R Miller et al Phlebology 2004 0/35 9/24 4/17 (n=76) 0% 37% 24% Malignancy/ Bowens Inflammatory features Non-healing suspicious Indication
- 29. Role of surgery Malignancy Biopsy Treat arterial disease Superficial venous disease
- 32. Dystrophic subcutaneous calcification Meidinger NEJM 2008
- 33. Role of surgery Malignancy Excision Calcification Biopsy Treat arterial disease Superficial venous disease
- 38. Role of surgery Malignancy Dystrophic calcification Biopsy Excision & grafting Treat arterial disease Superficial venous disease
- 48. Outreach clinic
Editor's Notes
- Elevated ABIs often indicate vascular calcification and this will ferquently co-exist with neuropathy. These patients are at risk for neuropathic foot ulcers and should be screened. Toe pressure are a better measure of perfusion in this patient group. In general, in our wound care guidelines, we recommend referral of known diabetics with leg ulcers for a vascular surgery opinion. However, where the ABIs are normla and the pulss are easily palpable we would ususally proceed with compression therapy. We do not rely on ABIs in those without palpable pusles and check toes pressures which requires equipment not usually found in community clinics in Ireland.
- Bacterial contamination is common – no correlation between these results and the outcomes and there is no need to treat. In fact, there is no need to send swabs at all as this incurrs unecessary cost and increases the risk that patients will be inappropriately treated with antibiotics on eh absis of swab results.
- The vast majority of venous ulcers are benign. There is a risk of malignant transformation in long standing venous ulcers – the so called Marjolins ulcer. This is no common and typically would occur in a very long standing ulcer. It is much more common for a primary (or even metastatic skin cancer to be misdiagnosed or mistreated as a venous ulcer. It is not possible to exclude malignancy based on appearance of the ulcer and any ulcer that faisl to progress with compression therapy or fails to heal within a reasonable time period should have a punch biopsy performed under local anaesthesia. Where there are facilities and expertise, this could be done in a nurse lead clinic or other community setting but, at least in our healthcare system, this will usually require referral to a hospital setting. This data from professor Harding’s wound care group shows that the incidence of unsuspected malignancy is quite high. In this small study, the ulcers were divided into three groups based on the indication for biopsy. As you can see, the ulcers which did not look suspicious for malignancy were more likely to harbour either a cancer or in situ carcinoma. The lesson of this study, and the bitter lessons of experience in any leg ulcer clinic is to biopsy liberally. We would propose that any ulcer which does not progress in 8 weeks or heal in 12 weeks should be biopsied.
- A french group…
- A french group…