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A venous ulcer tends to occur on the medial side of the leg, typically around the medial malleolus in the 'gaiter area' whereas arterial ulcer tends to occur on lateral side of the leg and over bony prominences. A venous ulcer is typically shallow with irregular sloping edges whereas an arterial ulcer can be deep and has a 'punched out' appearance.
Chronic wound pain is a condition described as unremitting, disabling, and recalcitrant pain experienced by individuals with various types of chronic wounds. [1] Chronic wounds such as venous leg ulcers, arterial ulcers, diabetic foot ulcers, pressure ulcers, and malignant wounds can have an enormous impact on an individual’s quality of life with pain being one of the most distressing symptoms.
Our body's vascular system is intricate and sophisticated - with the smallest blood vessel measuring 3 times smaller than a human hair
An arterial insufficiency ulcer in a person with severe peripheral artery disease [1] Specialty: Interventional radiology, vascular surgery: Symptoms: Leg pain when walking that resolves with rest, skin ulcers, bluish skin, cold skin, [2] [3] loss of hair, unusually smooth or shiny skin: Complications: Infection, amputation [4] Causes
Leg ulcer; CVI in the leg may cause the following: Venous stasis; Venous ulcers [8] Stasis dermatitis, [8] also known as varicose eczema; Contact dermatitis, [8] a disrupted epidermal barrier due to venous insufficiency, making patients more susceptible than the general population to contact sensitization and subsequent dermatitis.
Venous ulcers, which usually occur in the legs, account for about 70% to 90% of chronic wounds [2] and mostly affect the elderly. They are thought to be due to venous hypertension caused by improper function of valves that exist in the veins to prevent blood from flowing backward.
Critical limb ischemia is diagnosed by the presence of ischemic rest pain, and an ulcers that will not heal or gangrene due to insufficient blood flow. [3] Insufficient blood flow may be confirmed by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oxygen measurement (TcpO2 ), or skin perfusion pressure (SPP).
On inspection the clinician looks for signs of: trauma; previous surgery ()muscle wasting/muscle asymmetry; edema (swelling) erythema (redness); ulcers – arterial ulcers tend to be on the borders / sides of the foot, neuropathic ulcers on the plantar surface of the foot, venous ulcers tend on be on the medial aspect of the leg superior to the medial malleolus.
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