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• Vascular

o Chronic venous insufficiency

• 70% of all vascular wounds

• Distal, medial 1/3 of leg

• Haemosiderin

• Obesity, varicose vein problems, oedema of limb, past DVT, poor mobility

• Shallow wound

o Arterial; mixed; vasculitis

• Intermittent claudication, rest pain, cold or numb feet

• ABI (Ankle/brachial index) < 1

• Often includes ankle and foot

• Deep and irregular

• Painful

• Mechanical

• Pressure, friction, shear

• Trauma

• Neuropathic

• Loss of protective sensation

• Tissue is exposed to high weight-bearing forces/pressure

• Tissue trauma

• Surgical

• Malignancy

• Squamos cell carcinoma

• Kaposi’s sarcoma

• Malignant melanoma

• Infection

• Tuberculosis

• Mycetoma

• Other

• Pyoderma gangrenosum

Classification

• Grade 1

• Grade 2

• Grade 3

• Grade 4

Principals of ulcer management:

• Define aetiology, select appropriate dressing

• Control factors affecting healing, plan for management

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