Wound Care  Differences – Venous and Arterial Leg Ulcers

Wound Care Differences – Venous and Arterial Leg Ulcers

Wound Care – Do you know the key differences between Venous and Arterial Leg Ulcers?  As Nurses, you are aware that leg ulcer wounds can markedly impact the patient, their families and the Australian health care system.  Whilst Nurses do not ‘diagnose’, it is useful when caring for wounds to be aware of the most common visual differences between venous and arterial leg ulcers.

What is a Leg Ulcer?

As we know a leg ulcer is a defect in the skin or mucous membranes and is recognised as a type of wound. Whilst venous disease accounts for the majority of leg ulcers, other causes can include for example:

  • Arterial and peripheral vascular disease
  • diabetes
  • Varicose Veins
  • Trauma
  • Tumours
  • Vasculitis
  • Pyoderma gangrenosum

Do you know the practical clues that can assist you in identifying whether a leg Ulcer is Venous or Arterial in origin?

What can you tell by the location of the ulcer, the characteristics of the ulcer and the status of the leg itself?

We have created a good info sheet that you can download which identifies the key visual differences between venous and arterial leg ulcers – Download it and pop it up in your workplace as an easy reminder!

Which of the following do you think corresponds to either a Venous or Arterial Leg Ulcer?

 Minimal/ no hair
 Thin, dry and shiny skin
 Thickened toe nails
 Leg may be cool
 Leg becomes pale when elevated
 May have neuropathy
 Nil or diminished leg and foot pulses

Deep pale base
 Well defined edges
 Black or necrotic tissue
 Very painful
 Pain is reduced by lowering the leg to a dependent position

Reddish brown pigmentation known as Haemosiderin
 Evidence of past healed ulcers
 Oedema that may leak and cause maceration, varicose eczema, itchy skin and scale
 Dilated and tortuous superficial veins
 Legs may be warm
 Hair on legs
 Normal leg and foot pulses

Ulcer has uneven edges
 Ruddy granulation tissue
 No dead tissue
 Moderate to no pain at all
 Pain is present is eased by raising the leg

Wound assessment should be done in a systematic way based on the Standards for Wound Prevention and Management and it is useful for Nurses to be aware of the visual key differences between venous and arterial leg ulcers as we can gather information that is very useful in the assessment process and can assist in the appropriate selection of wound care products. So can you answer these questions?

What sort of ulcer is usually found on legs that still have hair on them?

Normal foot pulses are usually associated with what type of ulcer?

What sort of ulcer is usually very painful?

Which type of ulcer is usually associated with the client’s pain easing if the leg is raised?

Which type of ulcer usually has a pale deep base?

Which type of ulcer is often found on legs that have dry and shiny skin?

The Nurses for Nurses Network has a great range of Nursing Education and Nursing activities related to wound care including the best practice management of leg ulcers. The sessions are focused on Nurses who need to know about managing wound care in the ‘real world’ where Nurses are often time poor and resource limited!

Download your copy of the Ulcer Infosheet

Reference: https://www.dermcoll.edu.au/atoz/leg-ulcers/ viewed 1st August 2017

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