Ulcer Examination
An ulcer is an open sore on an external or internal surface of the body, caused by a
break in the skin or mucous membrane which fails to heal. Ulcers range from small,
painful sores in the mouth to bedsores and serious lesions of the stomach or
intestine.
General inspection:
This is a descriptive process similar to that of a lump or skin rash.
Remember to look at all aspects on the area affected.
Take your time with the inspection and try to comment as you go along.
Site – use anatomical descriptions and the no. of cm from the nearest bony
prominence.
Size – If you have a ruler measure the exact diameter, otherwise estimate.
Shape – Describe the shape (round, oval etc...)
Skin – Comment on the appearance of the surrounding skin.
Scars – e.g. from previous ulcers, skin grafts etc...
Colour – What colour is the ulcer?
Base – Presence of granulation tissue, slough (dead tissue), pus, bone or
tendon visible?
Edge – Is it punched out, sloping or undetermined where the edges hang over
the ulcer cavity?
Depth – Shallow or deep? Estimate depth in cm.
Palpation:
First, ask if the patient is in any pain.
Tenderness – observe the patients face while palpating.
Temperature – feel the surrounding skin and compare like-for-like.
Lymph nodes – check for swelling, as nodes provide local drainage.
Local tissue – assess the neurovascular status of the limb.
Ideally you would perform a full vascular examination of the affected limb,
assessing pulses and looking for signs of venous insufficiency.
An ulcer is an open sore on an external or internal surface of the body, caused by a
break in the skin or mucous membrane which fails to heal. Ulcers range from small,
painful sores in the mouth to bedsores and serious lesions of the stomach or
intestine.
General inspection:
This is a descriptive process similar to that of a lump or skin rash.
Remember to look at all aspects on the area affected.
Take your time with the inspection and try to comment as you go along.
Site – use anatomical descriptions and the no. of cm from the nearest bony
prominence.
Size – If you have a ruler measure the exact diameter, otherwise estimate.
Shape – Describe the shape (round, oval etc...)
Skin – Comment on the appearance of the surrounding skin.
Scars – e.g. from previous ulcers, skin grafts etc...
Colour – What colour is the ulcer?
Base – Presence of granulation tissue, slough (dead tissue), pus, bone or
tendon visible?
Edge – Is it punched out, sloping or undetermined where the edges hang over
the ulcer cavity?
Depth – Shallow or deep? Estimate depth in cm.
Palpation:
First, ask if the patient is in any pain.
Tenderness – observe the patients face while palpating.
Temperature – feel the surrounding skin and compare like-for-like.
Lymph nodes – check for swelling, as nodes provide local drainage.
Local tissue – assess the neurovascular status of the limb.
Ideally you would perform a full vascular examination of the affected limb,
assessing pulses and looking for signs of venous insufficiency.
