Arterial Ulcers

Jenna Wishnew, MD, FACS

General Surgeon located in Richardson, TX

Arterial ulcer also known as ischemic ulcer occurs when there is inadequate perfusion or poor blood flow to the legs. This poor blood flow means there is insufficient delivery of oxygen and nutrient-rich blood to the lower extremities leading to tissue death and causing the area to form an open wound. This ulcer may also originate from minor scrapes or cuts which failed to heal due to the lack of blood supply. These ulcers often form on the outer side of the ankle, feet, heels, or toes. These ulcers are usually painful and have a punched out circular appearance.

CAUSES

- Peripheral arterial disease

RISK FACTORS

- Age > 65 due to reduced subcutaneous fat and capillary blood flow

- Diabetes

- Smoking

- High blood pressure

- High cholesterol

- Kidney failure

- Trauma

- Atherosclerosis, or thickening of the arteries

- Vasculitis

- Limited joint mobility

- Foot deformity

- Poor footwear

 

TREATMENT

- Lifestyle changes: stopping smoking, change of diet with limit on lipid and cholesterol, and control of blood sugar

- Surgical debridement (Hyperlinked)

- Chemical debridement (Hyperlinked)

- Skin substitute graft (Hyperlinked)

- Skin graft (Hyperlinked)

- Hyperbaric oxygen therapy (Hyperlinked)

- Surgical revascularization of a limb i.e. bypass or angioplasty