Surgery Book

Dermatology

  • Arterial Ulcer

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Arterial Ulcer

Aka: Arterial Ulcer, Ischemic Ulcer of Skin, Peripheral Arterial Disease Related Chronic Skin Wound
  1. See Also
    1. Chronic Wound
    2. Venous Ulcer
    3. Claudication (Peripheral Arterial Disease)
    4. Peripheral Vascular Disease Management
  2. Signs
    1. Distribution
      1. Distal extremities
    2. Characteristics
      1. Deeper ulcers that may expose tendons and bone
      2. Punched-out lesions with well defined margins
  3. Evaluation
    1. See Claudication (Peripheral Arterial Disease)
    2. Initial screening with Ankle-Brachial Index
    3. Confirmation with arterial Doppler Ultrasound or segmental limb pressures
  4. Management
    1. See Peripheral Vascular Disease Management
    2. Restoration of adequate perfusion is paramount
    3. Healable Wound Care (adequate perfusion)
      1. See TIME Principle of Chronic Wound Care
      2. Apply topical skin Emollients (e.g. Aquaphor)
      3. Wound Debridement
    4. Nonhealable Wound Care (ischemic wounds)
      1. See Peripheral Vascular Disease Management for revascularization and other interventions
      2. Avoid Wound Debridement in ischemic wounds
      3. Control infection
      4. Apply topical skin Emollients (e.g. Aquaphor)
  5. References
    1. Bowers (2020) Am Fam Physician 101(3):159-66 [PubMed]

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