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Neuropathic Pain Guidelines 2011

Leg Ulcers 7 Facts About Leg Ulcers You Must Know

Leg ulcers are common approximately 2% of adults will have a leg ulcer at some stage in their lives. Literally thousands of people develop a leg ulcer each year in the United Kingdom and many of those get more leg ulcers as the years go by. Despite the misery they cause, leg ulcers remain a neglected problem. I am going to tell you the 7 essential facts should you know about leg ulcers. Number 1 What is an ulcer? The medical definition of an ulcer is a break in the epithelium of a body surface or lining. Many of us will be familiar with a mouth ulcer. This is a break in the cell lining the mouth. It can be caused by an injury such as biting the inside of the mouth by accident. Well if the.

Skin breaks down anywhere on the body it is called an ulcer. If the ulcer is on the leg and has been present for more than 6 weeks it is called a chronic leg ulcer. Number 2 What causes a leg ulcer? Four out of 5 ulcers that’s 80% are caused by a problem with the leg vein pump and they are called venous ulcers. The leg vein pump is the mechanism by which blood flows out of the leg back to the heart. So problems with the deep veins such as obstruction from a deep vein thrombosis, superficial vein reflux or perforator vein problems can cause venous leg ulcers. The leg vein pump depends mainly on good ankle movement, good calf muscles and healthy leg veins. A minority of leg ulcers about 15%.

are caused by problems in the arteries that carry blood into the leg. About 95% of venous leg ulcers can be correctly identified by their appearance, by checking for pulses in the feet and by checking sensation. As most leg ulcers are venous that’s what I am going to concentrate on. Number 3 Where on the leg do you get venous ulcers? Well venous leg ulcers appear on the lower part of the leg usually just about the ankle. Often, there are varicose veins or thread veins around the ulcer and the leg is usually swollen. The skin is often thickened and discoloured by varicose eczema which many actually develop many months or years before the ulcer as a warning sign that the vein circulation is.

Not normal. Number 4 Who gets a venous ulcer? Well these ulcers affect people who have deep vein problems, usually from a past deep vein thrombosis (DVT), people who have superficial venous disease or those with ankle mobility problems. Leg ulcers are more common as we get older. Number 5 How do you treat venous ulcers? The aim of treatment is to get the ulcer healed as quickly as possible. This usually means graduated compression either with bandages or compression stockings. In most cases, antibiotics, creams and ointments are not necessary. Once the ulcer is healed it is very important to identify any problems with the superficial veins or perforator veins and that these are treated to reduce the risk.

Of another ulcer. This means getting a full assessment with a duplex ultrasound scan. Number 6 Can you cure a leg ulcer? Well this is controversial. Some would say that if the problem is only in the superficial veins, the veins under the skin, or in the perforator veins that connect these superficial veins to the deep veins, then the ulcer can be cured. While there is good evidence that such treatment will greatly reduce the risks of getting another leg ulcer, if the skin has been very damaged and the ulcer has healed with a lot of scarring, this area of the leg may remain vulnerable and a trivial knock or injury might cause another skin breakdown even though the vein abnormality has been completely eradicated.

Number 7 How can we avoid leg ulcers? Well there are 3 things I would suggest. Firstly, if you are unfortunate enough to suffer a deep vein thrombosis (DVT), it should be treated promptly to limit the damage to the deep veins. Unfortunately, damage to the deep veins cannot be reliably reversed by surgery. So, prompt treatment with anticoagulants blood thinning medication reduces the extent of the clot and the damage to the deep veins. Secondly, if you have had a DVT, you should consider wearing good quality medical grade compression socks some studies suggest that doing so may reduce the risk of leg ulcers after a big DVT. Thirdly, if you have superficial vein reflux have it treated early to reduce.

The chances of progression to varicose eczema which is itself a warning sign that the skin is damaged and liable to ulceration. Now I hope you have found this useful. Don’t forget to subscribe to keep up to date with the latest on veins. Thank you for watching my tutorial.

Pain Awareness Month Story Landis on The Pain Consortium

Music Story Landis speaking NINDS was asked by Francis Collins who’s the director of NIH to serve as the lead Institute for pain and that means that we’re responsible for hosting the Pain Consortium and virtually every Institute and center at the National Institutes of Health funds pain research. For example the National Cancer Institute is very interested in.

Understanding pain after cancer treatment or during cancer. NIDA, the National Institute on Drug Abuse is particularly interested in how drugs that influence perception of pain act and developing better drugs. And my Institute the National Institute of Neurological Disorders and Stroke we’re particularly interested in in actually broad range research about the.

Underlying biological mechanisms that serve pain and understanding how we might better understand the circuits and intervene in them. Now obviously this is all gonna work better if the different institutes supporting pain research understand what each of them is doing and can coordinate and work together to make sure that we do the best possible job in supporting pain research. We have supported particular funding opportunity announcements that target particular.

Kinds of pain or ways of thinking about pain, like chronic overlapping pain conditions. We’ve sponsored workshops and symposia that bring scientists together to understand what are the big unsolved problems. In addition we’ve also this month which is Pain Awareness Month focused on a major effort to raise awareness in the American public about pain and that’s included Twitter chats and a radio tour with several people.

Participating in local radio shows answering questions from the audience and talking about and NIH, and pain and pain research. So we have a a broad range of activities that the pain consortium has undertaken.

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