In venous disease, ulcers are usually located in the gaiter area between the ankle and the calf, often on the medial aspect of the leg. Arterial leg ulcers occur as a result of reduced arterial blood flow and subsequent tissue perfusion.
What is the difference between venous ulcers and arterial ulcers?
They often form on the lower extremities, such as the legs and feet. Arterial ulcers develop as the result of damage to the arteries due to lack of blood flow to tissue. Venous ulcers develop from damage to the veins caused by an insufficient return of blood back to the heart.
How can you tell the difference between arterial venous and diabetic ulcers?
Typically, arterial ulcers are extremely painful. Venous ulcers can present with dull and achy pain in the entire leg, but the wound area itself usually doesn’t hurt unless it’s infected. Diabetic ulcers may present with the pins-and-needles pain or a loss of sensation that is associated with peripheral neuropathy.
How do you distinguish between arterial and venous insufficiency?
Both arterial and venous insufficiency share many of the same symptoms and characteristics, but they are actually quite different. Poor circulation in the arteries causes arterial insufficiency, while venous insufficiency occurs when blood flows poorly through the veins.
What is the most distinguishing characteristics of a arterial ulcers?
Arterial ulcers are characterized by a punched-out look, usually round in shape, with well-defined, even wound margins. Arterial ulcers are often found between or on the tips of the toes, on the heels, on the outer ankle, or where there is pressure from walking or footwear.
What does the start of a venous ulcer look like?
Venous leg ulcers often first look like red, irritated skin or rashes, but they develop into open wounds.
Are arterial ulcers wet or dry?
Typically, the ulcer itself is small, round, and smooth, with a “punched out” appearance and well-defined borders. The wound may be shallow or deep. The wound base typically is pale, dry, necrotic, and without granulation tissue (see photograph of an arterial ulcer on the foot).
What findings would you identify for a patient with a venous stasis ulcer?
Venous stasis ulcers are often on the ankle or calf and are painful and red. A yellow, fibrous tissue may cover the ulcer and have an irregular border. Drainage and discharge are common with venous stasis ulcers. This type of ulcer is common in people who have varicose veins or a history of leg swelling.
Are arterial ulcers shiny?
Characteristics of Arterial or Ischemic Ulcers Can Include:
Shiny or tight, hairless skin. Skin that is cool or cold to the touch.
How do you distinguish arterial bleeding?
Arterial bleeding is characterized by rapid pulsing spurts, sometimes several meters high, and has been recorded as reaching as much as 18-feet away from the body. Because it’s heavily oxygenated, arterial blood is said to be bright red.
What are the 5 P’s of arterial insufficiency?
The six Ps (pain, pallor, poikilothermia, pulselessness, paresthesia, paralysis) are the classic presentation of acute arterial occlusion in patients without underlying occlusive vascular disease.
What are two characteristics of arterial insufficiency?
Common symptoms of arterial insufficiency
Peripheral arterial insufficiency often leads to pain, aching, numbness or cramping in the arms or legs. Symptoms related to the arteries of the heart include: Chest pain or pressure. Difficulty breathing or rapid breathing (tachypnea)
Are venous ulcers deep and circular?
Venous ulcers rarely have a uniform, completely circular appearance. Instead, they are usually irregular, with varying depths within the ulcer. Although they may start out small, venous ulcers can grow significantly in size, especially if left untreated.
What color is a arterial ulcer?
Symptoms of Arterial Ulcers
The base of the wound typically does not bleed, and is yellow, brown, grey or black in color. Often the limb will feel cool or cold to the touch, and the extremity will have little to no distinguishable pulse.
Are arterial ulcers deep or shallow?
Arterial ulcers may be shallow or deep with sharp “punched out” borders. Oftentimes, the wound base is grey or yellow with associated gangrene and eschar (dry dark scab). Tissue surrounding the wound may be itchy, pale, and shiny [4,9,10].
Are venous ulcers deep or shallow?
Venous ulcers are shallow, usually around the ankle, with unhealthy granulation tissue and fibrinous exudate in the floor [Figure 1].
What is the most common site for venous ulcers?
Venous ulcers most often form around the ankles. Venous ulcers typically occur because of damage to the valves inside the leg veins. These valves control the blood pressure inside the veins. They allow it to drop when you walk.
How do you investigate a venous ulcer?
Duplex ultrasound is the first line of investigation, as it provides assessment of both reflux and obstruction conditions. In patients with iliofemoral pathology, axial imaging with computed tomography scan or magnetic resonance imaging should be performed.
What to put on venous ulcers?
Evidence-based treatment options for venous ulcers include leg elevation, compression therapy, dressings, pentoxifylline, and aspirin therapy. Surgical management may be considered for ulcers that are large in size, of prolonged duration, or refractory to conservative measures.
Should you Debride an arterial ulcer?
It is not appropriate to debride arterial ulcers as this may promote further ischaemia and lead to the formation of a larger ulcer. Choice of wound dressings will be dictated by the nature of the wound. Vasoconstrictive drugs such as non-selective β blockers should be avoided.
Do arterial ulcers have Slough?
Arterial ulcers
This is as marked in small ulcers as in larger ulcers. Their edges are often sharply defined and the ulcer is ‘punched out’. The base is often covered with slough.