Skin ulcers

Laura Smitherman
Mind Map by Laura Smitherman, updated more than 1 year ago
Laura Smitherman
Created by Laura Smitherman about 6 years ago
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Description

Mind Map on Skin ulcers, created by Laura Smitherman on 02/07/2015.

Resource summary

Skin ulcers
  1. full-thickness defect in epidermis
    1. Types
      1. Arterial
        1. symptoms/signs
          1. ulcer
            1. well defined edges
              1. 'punched out'
              2. V. PAINFUL
                1. deeper than venous
                  1. location
                    1. lateral surface of ankle & distal digits
                      1. bony prominences
                    2. Peripheral artery disease (PAD)
                      1. absent pulses
                        1. thin, shiny skin
                          1. absence of hair, poor nail growth
                            1. cold, blue skin
                              1. CLAUDICATION
                                1. rest pain in soles of feet when elevated
                              2. investigations
                                1. Ankle Branchial Pressure Index (ABPI)
                                  1. PAD = <0.9
                                  2. X-ray
                                    1. osteomyelitis
                                  3. management
                                    1. antibiotics
                                      1. vascular surgery referral
                                        1. vascular bypass
                                          1. angiography
                                          2. lifestyle
                                            1. Stop smoking
                                              1. Glycaemic control
                                            2. reduced blood flow due to narrowing of arteries -> ischaemia
                                            3. Venous
                                              1. symptoms/signs
                                                1. ulcer
                                                  1. irregular, undefined shape
                                                    1. superficial
                                                      1. location
                                                        1. medial malleolus
                                                      2. lipodermatosclerosis
                                                        1. tapering of leg above ankle
                                                          1. 'inverted champagne bottle'
                                                        2. haemosiderosis
                                                          1. brown hyperpigmentation
                                                            1. iron deposition in skin
                                                          2. varicose veins
                                                            1. previous DVT
                                                          3. management
                                                            1. compression stockings + elevation
                                                              1. after ABPI to rule out PAD
                                                              2. lifestyle/meds
                                                                1. surgery
                                                                  1. ablation
                                                                    1. sclerotherapy
                                                                      1. stripping
                                                                    2. investigations
                                                                      1. CVD/diabetic risk factors
                                                                        1. HbA1c
                                                                          1. BP
                                                                            1. lipid profile
                                                                          2. incompetent valves -> stasis/insufficiency
                                                                          3. Diabetic
                                                                            1. aetiology
                                                                              1. peripheral neuropathy
                                                                                1. reduced sensation/ proprioception
                                                                                  1. damage to pressure areas
                                                                                2. PVD
                                                                                  1. reduced healing
                                                                                3. symptoms/signs
                                                                                  1. deep, painless ulcer
                                                                                    1. on pressure area
                                                                                      1. callous formation
                                                                                      2. 'sock & glove' parasthesia
                                                                                        1. Hx of previous ulcers & slow healing
                                                                                        2. investigations
                                                                                          1. random glucose/ HbA1c
                                                                                            1. xray
                                                                                              1. ABPI
                                                                                              2. management
                                                                                                1. ulcer
                                                                                                  1. debridement
                                                                                                    1. regular cleaning & dressing change
                                                                                                      1. antibiotics prn
                                                                                                        1. vascular referral
                                                                                                        2. lifestyle/meds
                                                                                                          1. BP control
                                                                                                            1. glycaemic conrtol
                                                                                                              1. cholesterol control
                                                                                                                1. education
                                                                                                                  1. regular exercise
                                                                                                                  2. long term
                                                                                                                    1. Annual diabetic foot check
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