medical notes

Apr 16th, 2015
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CHRONIC LEG ULCERSIt is vital that any patient with leg ulceration has a full assessment. Lack of assessment can lead to long periods of inappropriate and potentially dangerous treatment. For example, applying compression bandaging to a limb where the arterial blood supply is compromised may result in gangrene; withholding compression bandagingwhere there is venous insufficiency may result in failure to heal and/or rapid extension of the ulceration.EtiologyThe most common cause of leg ulceration is tropical ulcers. Damaged to valves within the veinsresults in reflux of venous blood and consequenthigh pressures in the smaller vessels. This in turnleads to oedema and leakage of blood cells andfibrin into the tissues causing discolouration andhardening of the tissues (lipodermatosclerosis).These tissues are then prone to injury and onceinjured slow to heal. However, there are othercauses of ulceration and these should be excludedbefore treatment is begun. Other causes1. Arterial insufficiency to the lower limb2. Infections (tropical ulcers)3. Blood disorders (sickle cell anaemia)4. Neoplasms (squamous cell carcinoma, basal cell carcinoma5. Trauma6. Neuropathic (no

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