One of the following is not indicated for arterial leg ulcer -
Debridement
Elevation of limb
Head end of bed is raised
Low dose aspirin
Because gravity aids the delivery of arterial blood, classically, the patient with rest pain can obtain relief by simply hanging the leg over the side of the bed.
• Arterial insufficiency ulcers ischemic ulcers are mostly located on the lateral surface of the ankle or the distal digits.
• Most common on distal ends of limbs.
Etiology
• Caused by lack of blood flow to the capillary beds of the lower extremities.
• Most often endothelial dysfunction is causative factor in diabetic microangiopathy and macroangiopathy
Characteristic Features
• Punched-out appearance
• Intensely painful
• Pulses are not palpable
• Associated skin changes (thin shiny skin, absence of hair, brittle nails)
Diagnosis
• The lesion can be easily identified clinically.
• Arterial doppler and pulse volume recordings for baseline assessment of blood flow.
• Radiographs may be necessary to rule outosteomyelitis.
Treatment
• Vascular surgery to revascularize the area.
• In infection: Antibiotics + Debridement