Leg Ulcers
exp date isn't null, but text field is
Chronic ulcerative skin lesion caused by various aetiologies and often triggered by a minor trauma
Cause/Risk Factors
- Vascular, e.g. venous/arterial insufficiency
- Bacterial: leprosy, Buruli ulcer (by Mycobacterium ulcerans) etc
- Parasites: guinea worm, leishmaniasis
- Diabetes, sickle cell disease, malnutrition
Clinical Features
- Often in lower third of the leg
- Ulcerated lesion with necrotic tissue, slough, discharge, oedema around the lesion, scarring
- Features of cellulitis due to secondary infection may be present
- Features of underlying disease
Investigations
- Swab for C&S
- X-ray
- Blood glucose
ManagementTreatment
- Clean the wound
- If exudating/dirty lesions: use chlorhexidine solution 0.05% or hydrogen peroxide solution 6% or povidone iodine 2%
- If clean wound: use clean water or normal saline
- Remove necrotic tissue
- Elevate and rest the leg
- Perform daily dressing
- Apply silver sulphadiazine or povidone iodine if the wound is dirty and exudative
- Otherwise use gauze moistened with normal saline
- Analgesics for pain if needed
If sign of cellulitis
- Treat as per guidelines (see cellulitis)
Prevention
- Ensure personal hygiene
- Ensure good nutrition
- Avoid trauma