MEDI7212 Lecture Notes - Lecture 22: Nonsteroidal Anti-Inflammatory Drug, Gel, Hydrophile
Document Summary
Ulcers: most common chronic wounds seen in gp are leg ulcers (arterial, venous, mixed), pressure ulcers, skin tears and atypical wounds (eg vasculitic ulcers, clinical work up. History: history of pc, time course, pain, immobilisation. Fever, associated symptoms: past medical hx, diabetes, atherosclerotic disease, deconditioning or malnutrition, neuropathies. Skin - signs of chronic venous stasis, trophic changes. Surrounding tissue - inflammation, infection: arterial supply - arterial disease, abi, pedal pulses, bruits, venous drainage - varicosities, check gsv junction, neurological exam - neuropathy, sensation. Size and shape, depth: wound bed, exudate, pain, inflammation, infection. Investigations bloods - diabetes, malnutrition markers, inflammatory markers. Imaging - uss studies, angiography, lymphoscintigram: biopsy - diagnose malignant ulcer, types of skin wounds. Increased venous hydrostatic pressure: pitting oedema + reduced skin perfusion. Insufficient blood supply with no replenished o2, no waste turnover & stasis of clotting factors. Skin trauma is inadequately healed + ulcer formation: ulcer characteristics.
