Terms to Know: Lower Extremity Wounds

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By the WoundSource Editors

Collateral circulation: A collateral blood vessel circuit that may be adapted or remodeled to minimize the use of occluded arteries. Collateralization may offset some of the physiological signs of peripheral artery disease, such as maintaining a normal capillary refill.

Critical limb ischemia: A severe form of peripheral arterial disease in which a severe blockage of the arteries of the lower extremities reduces blood flow. It is a chronic condition that is often characterized by wounds of the lower extremity.

Dependent rubor: A light red to dusky-red coloration that is visible when the leg is in a dependent position (such as hanging off the edge of a table) but not when it is elevated above the heart. The presence of dependent rubor is often an indicator of underlying peripheral arterial disease. When the leg is raised above the level of the heart, its color will normalize.

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Elevational pallor: The presence of pallor in light-skinned patients and ashen coloring on darker-skinned patients on the soles of the feet. Elevational pallor can be assessed by raising the affected leg to 60 degrees for 30-60 seconds. The presence of elevational pallor indicates arterial occlusive disease.

Epibole: The presence of rolled edges that may be present within a full-thickness wound. This condition can be indicative of hypoxia, infection, trauma, or an unhealthy wound bed.

Hemosiderosis: Excessive accumulation of iron deposits in the tissue that causes edema and hyperpigmentation. Hemosiderosis is indicative of venous disease of the lower extremity.

Induration: The increase in fibrous elements in wound tissue that is associated with inflammation and an abnormal firmness of the tissue. Induration is usually indicative of infection in a lower extremity wound.

Low-reactive-level laser therapy: The use of photons in non-thermal irradiation to alter biological activity. This type of therapy enhances the activation of intracellular or extracellular chromophores and the initiation of cellular signaling by exposing cells or tissue to low levels of red or near infrared light. Biological effects include decreased inflammatory cells, increased fibroblast reproduction and angiogenesis, and stimulation of granulation tissue and augmented collagen synthesis.

Shockwave treatment: The use of biphasic, high-energy acoustic waves produced by electrohydraulics to alter biological activities. This type of treatment can increase the expression of macromolecules in wound healing, the proliferation of cell nuclear antigen, and endothelial nitric oxide synthesis. Shockwave therapy can decrease pain and assist with the healing process.

Telangiectasias: A condition in which widened venules cause intertwined lines or patterns on the skin. Clusters are called telangiectasias, and their presence can be indicative of venous insufficiency.

Undermining: Undermining of a wound demonstrates an area of tissue destruction below intact skin that forms a pocket on the periphery of a wound.

September is Lower Extremity Wounds Month

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

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