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