Glossary

Aetiology

The cause, set of causes, or manner of causation of a disease or condition.

Angiogram

Is a type of X-ray used to check the health of the blood vessels and how blood flows through them. It is used to help diagnose or investigate a number of problems affecting the blood vessels

Angioplasty

A procedure used to widen blocked or narrowed arteries.

Ankle flare

A fan shaped pattern of small, spiderlike, within the layers of the skin (intradermal) veins that occur on both the inside and outside aspect of the ankle and foot. They are thought to be an early sign of advanced venous disease.

Antibiotic

Substance or compound administered systemically or applied topically that acts selectively against bacteria.

Substance or compound administered internally (systemically) or applied externally / to the skin (topically) that slows the growth of or destroys microorganisms (e.g. bacteria).

Antimicrobial

Is a general term that refers to a group of drugs or substances used to reduce and treat infection by inhibiting or destroying micro-organisms.

Arterial Aneurysm

A pathological enlargement of an artery, becoming >50% larger than its normal diameter.

Arterial disease

Impaired blood flow in the arteries that generally occurs due to a build up of plaque. Plaque is made up of fat, cholesterol, calcium, fibrous tissue and other substances found in the blood.

Arterial insufficiency

Arterial insufficiency is any condition that slows or stops the flow of blood through your arteries.

Arterial leg ulcer

A wound on the leg and / or foot as a result of poor blood flow in the arteries.

Atherosclerosis

A condition where arteries become clogged with fatty substances (plaques) called atheroma. These plaques cause the arteries to harden and narrow, restricting the blood flow and oxygen supply to vital organs.

Atrophie blanche

Is a ‘star shaped’ ivory – white scarring that occurs on the lower leg or foot and mostly associated with venous insufficiency. It is due to the blockage of small blood vessels within the mid and deep layers of the skin which may result in abnormal wound healing. Prominent red dots may be seen within the scarring due to enlarged capillary blood vessels. This condition may be painful.

Bioengineered skin grafts

Manufactured skin replacement products derived from human or animal skin cells.

Cellulitis

A spreading bacterial infection underneath the skin surface, characterised by redness, warmth, swelling and pain. It commonly appears in areas where there is a break in the skin

Cellulitis is a skin infection that’s treated with antibiotics. It can be serious if it’s not treated quickly.

Chronic oedema

Is an umbrella term for the presence of swelling within the tissues of the body, caused by excess fluid that has been present for at least three months, most commonly due to problems with the venous and lymphatic systems.

Chronic venous insufficiency (CVI)

An advanced stage of venous disease that occurs over the long term and may involve skin changes or ulceration.

Compression therapy

Compression therapy improves the blood flow through the veins by applying external pressure to the leg. This can be done by bandaging the lower leg or by wearing compression socks, stockings or tights or sometimes Velcro wraps. Compression therapy is very effective at reducing swelling and healing or preventing wounds or ulcers

There are many different types of compression bandage available for the treatment of venous leg ulcers, some of which may be made up of two, three or four different layers. The application of a compression bandage is a skilled procedure and should be taught or applied by a trained healthcare clinician.

Deep vein thrombosis (DVT)

Deep vein thrombosis (DVT) is a blood clot that develops within a deep vein in the body, usually in the leg. Symptoms can include: Pain, swelling and tenderness in one of the legs, a heavy ache in the affected area, warm skin in the area of the clot or re skin, particularly at the back of the leg below the knee.

If a DVT is suspected, urgent medical advice should be sought immediately.

Diabetic foot ulcer

An area of broken skin on the foot affecting people with both type 1 and type 2 diabetes. The ulcer commonly starts as minor trauma but can deteriorate due to complications from high blood glucose levels, neuropathy (nerve damage) and reduced arterial blood flow.

Anyone with diabetes who develops a wound to their foot should always seek urgent advice from their nurse or podiatrist.

Doppler

A Doppler ultrasound is a test that uses high-frequency sound waves. It is often used by healthcare professionals to measure the ankle brachial pressure index (ABPI) in order to detect abnormal flow within an artery (blood vessel). This is required before applying compression therapy for patients with lower leg and foot conditions.

Doppler ultrasound

Refer to Doppler.

Duplex scan

This is a painless examination that uses high frequency sound waves (ultrasound) to capture internal images of the arteries or veins. A clinical gel is placed on the area being examined whilst a transducer (a wand – like device) is passed lightly over the skin above the artery or vein.

Emollient

A moisturising product specially designed to prevent the skin from becoming dry and help protect it from irritants.

Extensibility

The ability of a bandage to increase its length in response to an applied force.

Exudate

A fluid rich in protein and cellular elements that oozes out of blood vessels due to inflammation and is deposited in nearby tissues. This is the fluid present in wounds.

Gaiter area

The area on the leg that is between the knee and the ankle.

Haemosiderin

A purple or reddish brown pigmentation of the skin, due to deposit and breakdown of red blood cells (hemosiderin) in the lower legs as a result of venous insufficiency.

Health care professional

A person who maintains health in humans through the application of evidence (e.g. research) based practice.

Hyperkeratosis

A thickening of the stratum corneum (the outermost layer of the epidermis), often associated with the presence of an abnormal quantity of keratin, and also usually accompanied by an increase in the granular layer. On the legs, it often presents as dry, crusty plaques and is commonly associated with venous insufficiency.

Immunosuppressive medication

Medication which suppresses, or reduces, the strength of the body’s immune system.

Infection

A disease in part of your body that is caused by bacteria or a virus.

Intermittent claudication

A condition in which cramping pain in the leg is induced by exercise and is relieved by a short period of rest. Typically caused by obstruction of the arteries.

Ischemia: actue limb

An inadequate blood supply and flow to a limb, such as a lower leg – resulting in decreased oxygen and nutrient supplies.

Lipodermatosclerosis

Skin changes to the lower legs caused by inflammation of the subcutaneous fat. It is commonly associated with venous insufficiency.

Lipoedema

Lipoedema is a long-term (chronic) condition where there’s an abnormal build-up of fat cells in the legs, thighs and buttocks, and sometimes in the arms.

The condition usually only affects women, although in rare cases it can also affect men.

Lymphatic drainage

Removal of fluid and cells and particles that are no longer needed from the interstitial spaces. Cells and particles include, decaying or dead cells, used protein molecules, fat cells, bacteria, together with lymphocytes and macrophages that have gathered to neutralise bacteria and mutant cells. Inability to remove these causes a build up of fibres in the interstitial spaces and an inflammatory response.

Lymphatic insufficiency

Lymphatic insufficiency is a term used for lymphatic disorders such as lymphoedema. It is related to the failure of the lymphatic draining system which results in accumulation of lymphatic fluid in the tissues which causes swelling

Lymphatic system

The lymphatic system has an important role in protecting the body from infection. Part of that involves the removal of fluid and cells that might be harmful, such as bacteria, from all around the body, via a network of vessels similar to veins. The fluid within the lymphatic vessels is called lymph. The collection and movement of the unwanted fluid and cells depends mainly on movement and activity to ensure it works properly.

Lymphoedema

Lymphoedema is a long-term (chronic) condition that causes swelling in the body’s tissues. It can affect any part of the body, but usually develops in the arms or legs.

It develops when the lymphatic system doesn’t work properly. The lymphatic system is a network of channels and glands throughout the body that helps fight infection and remove excess fluid.

Macrocirculation

The circulation of blood through larger vessels (arteries and veins) to and from the organs in the body.

Microcirculation

The flow of blood in the smallest blood vessels (arterioles, capillaries and venules). The main functions are the delivery of oxygen and nutrients and the removal of carbon dioxide.

Mixed aetiology leg ulcer

Condition is mainly associated with venous insufficiency but there is also some underlying arterial disease present.

Neuropathic pain

Neuropathic pain can be described as a burning or hot pain, shooting or sharp that gives no warning. This type of pain needs different medication and is not reduced with paracetamol or codeine.

Oedema

Oedema is a buildup of fluid in the tissues of the body.

The swelling can occur in one particular part of the body (for example the feet or ankles), or may be more general, depending on the cause.

Pain

An unpleasant sensation that can range from mild, localised discomfort to agony. Pain has both physical and emotional parts, the physical resulting from nerve stimulation. Pain may be contained to a small area, such as an injury, or it may be more widespread.

Patient

Any person receiving health assessment, care or treatment from a health care provider.

Peripheral artery disease (PAD)

Is a common condition, in which a build -up of fatty deposits in the arteries restricts bloods supply to the leg muscles. It is also known as peripheral vascular disease.

Popliteal aneurysm

A popliteal aneurysm is bulging and weakness in the wall of the popliteal artery, which supplies blood to the knee joint, thigh and calf. A popliteal aneurysm can burst, which may cause life-threatening, uncontrolled bleeding. The aneurysm may also cause a blood clot, potentially requiring a leg amputation.

Popliteal Artery

One of the main vessels constituting the lower limb’s “arterial tree”. It is in continuity with the Common (CFA) and Superficial Femoral (SFA) arteries originating in the groin; the popliteal artery runs behind the knee-joint (popliteal fossa). It branches out into three small arteries (Anterior Tibial, Posterior Tibial and Peroneal arteries) providing the blood flow to the lower leg and the foot.

Post-thrombotic syndrome

Describes signs and symptoms that occur due to long-term complications of lower limb DVT. Signs and symptoms include leg aching and cramping, itching, heaviness, skin discolouration and VLU.

Pyoderma Gangrenosum

A rare treatable cause of skin ulceration. It is not a type of gangrene. The cause of Pyoderma Gangrenosum is often not known. Pyoderma Gangrenosum is often referred to as PG.

Red leg

A condition commonly seen in people with chronic venous disease, chronic oedema or lower limb dermatological conditions. Red legs typically present with redness that affects both legs, normally in the lower limbs, and is accompanied by warmth and tenderness in the area. Because of this, it is often misdiagnosed as cellulitis

Resting pressure

The sub-bandage pressure experienced whilst the patient is at rest.

Sickle Cell ulceration

Sickle Cell ulcers of the lower leg and foot only occur in people who have a diagnosis of Sickle Cell disease. They remain relatively a rare condition but can be extremely debilitating.

Standard care

A standard is something that serves as a basis for comparison against and is established as a measure or model to which care should conform. Standards tend to be written by experts and define a health providers position to provide quality care.

Steroid creams

Steroid creams (or ointments), also referred to as topical steroids, are anti-inflammatory preparations used to control eczema, dermatitis and many other skin conditions.  They come in a range of strengths and should always be used as advised by the health professional who prescribes them.

Tissue viability nurse

A specialist nurse who advises on all aspects of skin health and wound care and who helps to facilitate healing in wounds where a complication has prevented the normal healing process.

Varicose eczema

Varicose eczema, also known as venous, gravitational or stasis eczema, is a long-term skin condition that affects the lower legs. It’s common in people with varicose veins.

The condition occurs as a result of blood pooling in the veins from insufficient venous return

Varicose eczema tends to be a long-term problem. However, treatments are available to help keep it under control.

Varicose veins

Varicose veins are swollen and enlarged veins that usually occur on the legs and feet. They may be blue or dark purple, and are often lumpy, bulging or twisted in appearance. They occur as a result of venous insufficiency which leads to high pressure in the veins.

Venous disease

Venous disease is caused by a functional abnormality in the veins that prevents the blood flowing back properly to the heart, causing it to pool in the veins in the legs. Either superficial or deep veins may be affected.

Venous hypertension

A symptom of venous disease. The malfunctioning / incompetent valves in the veins leads to the blood pooling and an increase in blood pressure in the veins. This is known as venous hypertension.

Venous insufficiency

Refer to venous disease.

Venous leg ulcer

An open wound / sore between the knee and the ankle that remains unhealed for at least four weeks and occurs in the presence of venous disease.

Many venous leg ulcers start as a traumatic wound.

Working pressure

The sub-bandage pressure experienced as the patient walks.

Wound

A wound is a breakdown in the protective function of the skin following injury to the skin or underlying tissues / organs.

Wound healing

The process by which the body replaces and restores the function of damaged tissue.