Assessing and managing patients with leg ulceration and oedema

Leg ulcers are some of the most common wounds treated by the NHS. Ulceration is usually classified as being of venous or arterial origin. Arterial ulcers develop because of reduced arterial flow to the leg caused by peripheral arterial disease. Venous leg ulcers, the most common form, develop because of vein incompetence, with valve failure leading to pressure in the veins. Nurses working with patients with oedema find that chronic oedema can cause the limb affected to swell, causing skin to stretch and break and lead to ulceration. This is known as superficial ulceration. This article discusses the causes, assessment and management of these different types of leg ulcer.

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Assessing and managing patients with leg ulceration and oedema

Journal of Prescribing Practice ◽

10.12968/jprp.2020.2.1.30 ◽

2020 ◽

Vol 2 (1) ◽

pp. 30-35

Author(s):

Marie Todd

Keyword(s):

Peripheral Arterial Disease ◽

Arterial Disease ◽

Leg Ulcer ◽

Arterial Flow ◽

Leg Ulcers ◽

Prescribing Practices ◽

Superficial Ulceration ◽

Venous Leg Ulcers ◽

Different Types ◽

Peripheral Arterial

Leg ulcers are some of the most common wounds treated by the NHS. Ulceration is usually classified as being of venous or arterial origin. Arterial ulcers develop because of reduced arterial flow to the leg caused by peripheral arterial disease. Venous leg ulcers, the most common form, develop because of vein incompetence, with valve failure leading to pressure in the veins. Nurses working with patients with oedema find that chronic oedema can cause the affected limb to swell, causing skin to stretch and break and lead to ulceration. This is known as superficial ulceration. This article discusses the causes, assessment and prescribing practices of these different types of leg ulcer.

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Venous Leg Ulcers in Patients with Concomitant Peripheral Arterial Disease

Annals of Vascular Surgery ◽

10.1016/j.avsg.2017.06.028 ◽

2017 ◽

Vol 43 ◽

pp. 54

Author(s):

Antonio J. Covarrubias ◽

Christian Bianchi ◽

Theodore Teruya ◽

Rahul Sharma ◽

Sharon Kiang ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Arterial Disease ◽

Leg Ulcers ◽

Venous Leg Ulcers ◽

Peripheral Arterial

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Chronic leg ulcer is a strong predictor to determine the major cardiovascular events in diabetic patients with peripheral arterial disease in Thailand

International Journal of Diabetes in Developing Countries ◽

10.1007/s13410-017-0593-y ◽

2017 ◽

Vol 38 (4) ◽

pp. 461-470

Author(s):

Rungrujee Kaweewan ◽

Saritphat Orrapin ◽

Natapong Kosachunhanun ◽

Kiran Sony ◽

Nimit Inpankaew ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Cardiovascular Events ◽

Strong Predictor ◽

Arterial Disease ◽

Leg Ulcer ◽

Diabetic Patients ◽

Major Cardiovascular Events ◽

Peripheral Arterial

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The Effect of Peripheral Arterial Disease on Arterial Flow Kinetics

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000495730.64064.2e ◽

2014 ◽

Vol 46 ◽

pp. 745

Author(s):

Hui-Ju Young ◽

Jared Brizendine ◽

Melissa Erickson ◽

Terence Ryan ◽

Xiao Li ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Arterial Disease ◽

Arterial Flow ◽

Peripheral Arterial

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Exercise performance in patients with peripheral arterial disease who have different types of exertional leg pain

Journal of Vascular Surgery ◽

10.1016/j.jvs.2007.02.037 ◽

2007 ◽

Vol 46 (1) ◽

pp. 79-86 ◽

Cited By ~ 23

Author(s):

Andrew W. Gardner ◽

Polly S. Montgomery ◽

Azhar Afaq

Keyword(s):

Peripheral Arterial Disease ◽

Exercise Performance ◽

Arterial Disease ◽

Leg Pain ◽

Different Types ◽

Peripheral Arterial

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Leg ulcers in peripheral arterial disease (arterial leg ulcers): Impaired wound healing above the threshold of chronic critical limb ischemia

Journal of the American Academy of Dermatology ◽

10.1067/mjd.2000.108375 ◽

2000 ◽

Vol 43 (6) ◽

pp. 1001-1008 ◽

Cited By ~ 38

Author(s):

Jürg Hafner ◽

Iris Schaad ◽

Ernst Schneider ◽

Burkhardt Seifert ◽

Günter Burg ◽

...

Keyword(s):

Wound Healing ◽

Peripheral Arterial Disease ◽

Critical Limb Ischemia ◽

Limb Ischemia ◽

Arterial Disease ◽

Leg Ulcers ◽

Impaired Wound Healing ◽

Chronic Critical Limb Ischemia ◽

Peripheral Arterial

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Level of Agreement Between Systematic Doppler Examination of the Lower Extremity and Diagnostic Angiography in the Setting of Peripheral Arterial Disease

Journal of the American Podiatric Medical Association ◽

10.7547/18-140 ◽

2021 ◽

Vol 111 (3) ◽

Author(s):

Timothy Greene ◽

Todd Hasenstein ◽

Eric T. Choi ◽

Andrew J. Meyr

Keyword(s):

Peripheral Arterial Disease ◽

Arterial Disease ◽

Arterial Flow ◽

Peroneal Artery ◽

Foot And Ankle ◽

Doppler Examination ◽

Examination Technique ◽

Diagnostic Angiography ◽

Peripheral Arterial ◽

Level Of Agreement

Background The objective of this investigation was to determine the level of agreement between a systematic clinical Doppler examination of the foot and ankle and diagnostic peripheral angiography. Methods The described Doppler examination technique attempted to determine the patency, quality, and direction of the flow through the dorsalis pedis artery, posterior tibial artery, terminal branches of the peroneal artery, and vascular arch of the foot. These results were then compared with angiographic distal run-off images as interpreted by a blinded vascular surgeon. Results Levels of agreement with respect to artery patency/quality ranged from 64.0% to 84.0%. Sensitivity ranged from 53.8% to 84.2%, and specificity ranged from 64.7% to 91.7%. Agreement with respect to arterial flow direction ranged from 73.3% to 90.5%. Conclusions We interpret these results to indicate that this comprehensive physical examination technique of the arterial flow to the foot and ankle with a Doppler device might serve as a reasonable initial surrogate to diagnostic angiography in some patients with peripheral arterial disease.

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