Arterial Ulcers

These are most often found on the areas of your legs and feet that are bony, such as your ankles and the tips of your toes. These areas rub against other things and cause friction on your skin.

An arterial ulcer is the hardest type of wound to heal. If it does not heal as it should, it can lead to the loss of your foot or leg. You need to follow your doctor or nurse's advice about how to treat your hurt to help it heal as fast as possible.

As part of your daily foot care, you need to look for any signs of an arterial ulcer. If you have one, it will most likely:

• have a regular shape that is round, has a punched out appearance
• not drain, or drain just a little
• Be very painful especially at night, causing burning, throbbing and stabbing pains (unless you've lost the feeling in your legs or feet) The pain is normally relieved by keeping legs in dependent position such as dangling legs over the edge of the bed . Individuals may prefer to sleep in a chair which has a negative impact on the healing potential.
• be pale pink, gray or black
• be dry to the touch
• have little or no pulse in the area around it
• cause the skin around it to be cool or cold
• be found on the top of your foot, close to your ankles or on your toes
• minimal to no hair growth on lower limbs

Risk factors for arterial ulcers may include:

• Vascular insufficiency
• Uncontrolled Diabetes Mellitus with poor glycemic control
• Limited joint mobility
• Inadequate footwear
• Structural foot abnormality, ie. Charcot foot
• Retinopathy (poor eye sight)
• renal disease
• History of ulcers
• Increased age

Unlike venous leg ulcers, compression therapy is NOT appropriate for treatment of arterial ulcers and a referral is required to a vascular specialist. Where possible the aim will be to revascularize the limit. If surgical intervention is not appropriate, wound management products will be utilized. The dressing is determined by the appearance of the wound bed and the amount of drain. Often times the wound bed is covered with slough; therefore, it is necessary to debride the wound. Debridement can be achieved through several different methods. Since arterial ulcers are painful, it is best to use enzymatic or autolytic debridement along with a non-adherent dressing for easy removal.

Using an oil emulsion dressing will prevent dressing from adhering to wound bed as well as hold in moisture to aid in debridment process.