Lower‐extremity ulcers: diagnosis and management

Abstract

Chronic wounds of the lower extremities are occurring with increasing prevalence. They affect millions of individuals annually, representing both a significant health risk and a large economic burden. Chronic wounds are associated with increased mortality and substantial morbidity due to infection, pain, limitation of daily activities, and psychosocial consequences. To manage these wounds effectively, clinicians must be able to diagnose and manage their aetiology. Diagnosis starts with determining whether the wound is one of the four most common chronic wounds: venous leg ulcers, diabetic foot ulcers, pressure ulcers and arterial ulcers. Moreover, despite many recent advances in wound care, the challenge of managing chronic wounds is complicated by the lack of consistently accepted diagnostic methods and wound-care standards. We present a comprehensive yet condensed approach to managing lower-extremity ulcers, from diagnosis to basic management.

Fundamental supply of skin blood flow in the Chinese Han population: Measurements by a full‐field laser perfusion imager

“…25,26 The lowest value is seen on anterior pretibial, it can attribute to the fact that the blood supply is lack of arteriovenous shunt, which can explain why wounds on the lower leg heal more slowly than elsewhere. 27 Our results show a tendency that perfusion values are higher in men than women, the difference can be seen on bank of fingertips, nose, forehead, cheek, neck, and earlobe, which is similar to some preceding researches. [28][29][30] There are several possible explanations, Goldberg J held the view that epidermis in female was thinner seemed most plausible.…”

“…It may partly attribute to the distributional or functional differences in cutaneous appendages such as sebaceous glands and sweat glands . The lowest value is seen on anterior pretibial, it can attribute to the fact that the blood supply is lack of arteriovenous shunt, which can explain why wounds on the lower leg heal more slowly than elsewhere …”

Wound Closure in Smoking Peripheral Arterial Disease Patients With Treatment-Refractory Ulcerations

“…In addition to ankle brachial index (ABI) values, the Fontaine classification system was used to classify the severity of PAD. 27-30 Clinical manifestations of PAD ranged from moderate to severe intermittent claudication in conjunction with minor tissue loss and nonhealing ulcerations. The classification of a wound as recalcitrant depended on a minimum previous treatment duration of ≥120 days (4 months) characterized by a prior failure to respond SOC and ≥1 advanced therapy regimens.…”

All about compression: A literature review

“…Kirsner 10 identified that application of compression on the limb can minimize or reverse venous reflux caused by valve incompetence, forcing fluid present in the interstitial spaces to return to the vascular and lymphatic systems, thus reducing tissue edema. However, this solution is temporary and would work only while the patient is wearing the compressive device, implying in the use of elastic stockings even after the ulcer has healed.…”