Features of venous ulcer
- Hyperpigmentation
- Medial or lateral malleolus
- Not associated with significant pain
Superficial thrombophlebitis Mx
Naproxen
Improving venous ulcer mx / prophylaxis against further lesions
Compression stockings
Features of arterial ulcer
- Deeply penetrating
- Reduced vibration sense
AAA screening programme
Surgical mx for claudication
1) aortoiliac disease
2) femoropopliteal disease
1) aortobifemoral bypass graft
2) femoropopliteal bypass graft
Mx for necrotic tissue on ulcer
Sharp debridement
Acute v critical limb ischaemia
Acute
Occurs due to formation of clots/ blood vessel blockage
- 6Ps
- Emergency
- Sudden
Critical
Occurs due to blockage/ narrowing of arteries in the lower extremities
- Limb is pink
- Gradual
Mx for acute limb ischaemia! pls confirm
- High flow O2
- Unfractionated heparin infusion
+/- surgical intervention - embolectomy
What is normal ABPI?
1-1.4
What is mx for ABPI 0.9-1.4 with intermittent claudication?
structured exercise program is recommended
What is mx for ABPI <0.9?
Peripheral arterial disease (PAD)
- Lifestyle modifications, e.g., smoking cessation, regular exercise, and healthy diet
- Med: antiplatelet therapy and statins
Blood supply to lower limb
- From common iliac!
- Internal iliac: booty
- External iliac: upper thigh
- ^ Common femoral: lower thigh
- ^ Superior femoral: calf
