Vascular Ulcers

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Types of Vascular Ulcers and Their Treatments

This presentation is going to be on the management and treatment of vascular ulcers. During this presentation, the listener will learn how to first understand the main categories of vascular ulcers. They will also be able to list the risk factors for peripheral arterial disease. They will understand how to diagnose peripheral arterial disease and be able to recognize the signs of severe peripheral arterial disease. They should also understand how to use Doppler’s and ankle-brachial indexes in the treatment and diagnosis of peripheral arterial disease, and finally be able to understand the treatment of arterial and venous ulcers.

How To Perform an ABI

I like to divide the vascular diseases into two different categories. The first being arterial disease. The main one of concern is peripheral arterial disease that we’ll discuss in greater detail. And in those that are non arterial in nature. This would include venous inefficiencies, lymphedema, and deep venous thrombosis.

Peripheral arterial disease is atherosclerosis leading to narrowing of the major arteries distal to the aortic arch. In theory, this can occur in the upper extremities and the lower extremities, but for the most part, we generally see wounds that are on the lower extremity. The narrowing generally occurs in the aortic division into the iliaca or further down into the leg. Often, these can be bypassed with surgery.

The most common presenting symptom is claudication, usually intermittent claudication. Patients will have pain on exertion when walking, but it goes away whenever they sit down and rest for 10 minutes or so.

Up to 40% of the people that have peripheral arterial disease will actually be asymptomatic. It affects anywhere from 15 to 20% of the people in our age group population that we’re seeing. Those people in nursing homes over the age of 70, about 15 to 20% of those people will have peripheral arterial disease.