Arterial Ulcers

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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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By the WoundSource Editors

Lower extremity ulcers, such as venous and arterial ulcers, can be complex and costly and can cause social distress. An estimated 1% of the adult population is affected by vascular wound types, and 3.6% of those affected are older than 65 years of age. Many factors contribute to lower extremity wound chronicity, including venous disease, arterial disease, neuropathy, and less common causes of metabolic disorders, hematological disorders, and infective diseases. A total of 15% to 20% of lower limb ulcers have a mixed etiology.

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Ulcerative Wounds

By the WoundSource Editors

Ulcers in the lower extremities are more common in patients older than 65. Ulcerative wound types include venous, arterial, diabetic neuropathic, and pressure. To identify ulcer types, these wounds should be examined thoroughly for their distinct characteristics such as location and shape, as well as in conjunction with other patient information, to ensure an accurate diagnosis and treatment plan.

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Factors Contributing to Complex Wounds

By the WoundSource Editors

A vast percentage of wounds become chronically stalled because of mixed etiology and other underlying comorbid medical conditions. This means the wound is multifactorial, and using a singular approach won’t be enough. Lower extremity wounds, for example, can have diabetes, venous and arterial issues, and pressure all as factors playing into the same wound.

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Wound Chronicity

by the WoundSource Editors

Chronic wounds affect over 6.5 million people annually in the United States, with a total cost of over $26.8 billion per year. Proper identification of chronic wounds is necessary to develop an effective treatment plan, although many elements—such as intrinsic and extrinsic factors, comorbidities, and mixed etiologies—may complicate this process.

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Chronic Wounds

by the WoundSource Editors

In approaching the management of a chronic wound, the first step in developing a treatment plan that will combat chronicity and promote healthy healing of damaged tissue begins with understanding the different types of wounds.

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Arterial Wounds

By Martin D. Vera LVN, CWS

As we move forward in our continuation of lower extremity wounds, we will now turn our attention to arterial wounds. In my previous post, we discussed challenges with venous leg ulcers. Lower extremity wounds continue to challenge clinicians on a daily basis. We often refer to them as "the big three" – or how I like to refer to them, "the pesky triplets." It doesn't matter what we call them, we know we are referring to venous leg ulcers, arterial ulcers, and diabetic foot ulcers. In no way shape or manner will we disregard the many other types of lower extremity wounds we may encounter as wound clinicians, but these three are the most common and often present with treatment challenges.

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hand wound

By Bruce E. Ruben MD

A non-healing wound is generally defined as a wound that will not heal within four weeks. If a wound does not heal within this usual time period, the cause is usually found in underlying conditions that have either gone unnoticed or untreated. In general, there are five reasons why wounds will not heal and more than one of these conditions can be operating at the same time.

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Aletha Tippett MD's picture

By Aletha Tippett MD

In considering this question as to whether amputation can be palliative, let’s keep clear that these are two separate subjects that sometimes interact. It is key to always keep our goals in mind. What is the goal in palliative care? The goals are to provide comfort, relieve pain, prevent infection, and improve or maintain quality of life. These goals are always to be in concert with the desires and wishes of the individual patient.

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Laurie Swezey's picture

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Arterial ulcers can cause much pain for patients and consternation for the wound care professionals tasked with managing them. Arterial ulcers can be a catch-22 in that many patients with arterial ulcers present with edema, but due to the nature of their problem cannot be safely compressed.