{"id":1804,"date":"2017-11-29T10:59:57","date_gmt":"2017-11-29T10:59:57","guid":{"rendered":"http:\/\/papergp.com\/index.php\/cardiovascular\/leg-ulcers\/"},"modified":"2023-01-24T11:25:26","modified_gmt":"2023-01-24T11:25:26","slug":"leg-ulcers","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/others\/vascular-surgery\/leg-ulcers\/","title":{"rendered":"Leg ulcers"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4><strong>Differential diagnosis<\/strong><\/h4>\n<ul>\n<li>Venous stasis\/hypertension<\/li>\n<li>Arterial insufficiency<\/li>\n<li>Neuropathy<\/li>\n<li>Vaculitis<\/li>\n<li>Neoplastic causes e.g. BCC, SCC<\/li>\n<li>Trauma<\/li>\n<li>Haematological e.g. leukaemia<\/li>\n<li>Infection<\/li>\n<li>Metabolic e.g. gout<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4><strong>Data gathering<\/strong><\/h4>\n<ul>\n<li>History\n<ul>\n<li>Duration of ulcer<\/li>\n<li>Pain<\/li>\n<li>Vascular risk factors &#8211; DM, MI, PVD, DVT, Varicose veins<\/li>\n<li>Intermittent claudication symptoms<\/li>\n<li>Previous Treatments<\/li>\n<\/ul>\n<\/li>\n<li>Examine\n<ul>\n<li>Inspect\n<ul>\n<li>atrophy, hair loss &#8211; may suggest poor perfusion and hence arterial ulcer<\/li>\n<li>eczematous changes &#8211; may be a result of venous eczema<\/li>\n<li>infective changes<\/li>\n<li>well demarcated &#8211; arterial<\/li>\n<li>irregular ulcer &#8211; venous<\/li>\n<\/ul>\n<\/li>\n<li>Location\n<ul>\n<li>in the \u201cgaiter\u201d area (i.e. area extending from just above the ankle to below the knee and tends to occur on both lateral and medial aspect of the leg)<\/li>\n<li>over pressure points &#8211; arterial and neuropathic<\/li>\n<li>over bony prominence &#8211; consider osteomyelitis<\/li>\n<\/ul>\n<\/li>\n<li>Measure ulcer<\/li>\n<li>Foot pulses<\/li>\n<li>Foot temperature<\/li>\n<li>Vital signs &#8211; BP, HR, temperature, CRT<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4><strong>Clinical management\u00a0<\/strong><\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>Bloods &#8211; FBC, U+E, LFT, HbA1c, lipids<\/li>\n<li>X-ray &#8211; if considering osteomyelitis<\/li>\n<li>ESR &#8211; if considering vasculitis<\/li>\n<li>ABPI &#8211; if considering arterial cause<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Treatment\n<ul>\n<li>Depending on aetiology\n<ul>\n<li>Non-healing, persistent, worsening ulcer &#8211; may require biopsy<\/li>\n<li>Simple traumatic ulcer &#8211; nurse dressing may be enough<\/li>\n<li>Biopsy &#8211; if considering malignancy<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Follow-up \/ Safety-net\n<ul>\n<li>Consider district nurse\/TVN to dress and monitor<\/li>\n<li>Consider dermatology for biopsy<\/li>\n<li>Consider vascular surgery for arterial causes<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Differential diagnosis Venous stasis\/hypertension Arterial insufficiency Neuropathy Vaculitis Neoplastic causes e.g. BCC, SCC Trauma Haematological e.g. leukaemia Infection Metabolic e.g. gout &nbsp; Data gathering History Duration of ulcer Pain Vascular risk factors &#8211; DM, MI, PVD, DVT, Varicose veins Intermittent claudication symptoms Previous Treatments Examine Inspect atrophy, hair loss &#8211; may suggest poor perfusion and &hellip; <a href=\"https:\/\/papergp.com\/index.php\/others\/vascular-surgery\/leg-ulcers\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Leg ulcers<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":2308,"menu_order":194,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1804","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1804","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=1804"}],"version-history":[{"count":3,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1804\/revisions"}],"predecessor-version":[{"id":1897,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1804\/revisions\/1897"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/2308"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=1804"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}