Arterial vs. Venous Ulcers
By Bryan C. Kramer, MD - February 24, 2020
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| Arteries bring oxygenated blood from the heart to the tissues | Veins return blood to the heart |
| Limb Threatening Condition- Leg loss above/below knee if untreated | NON-Limb Threatening Condition |
| Typical wounds begin at toes and progress up the foot | Wounds of CALF and ANKLE, associated with brown/red/purple skin discoloration and texture changes from the ankle to the knee |
| Cause is lack of arterial blood flow/oxygen to the tissues preventing healing. The tips of the toes have the worst blood flow, so the wounds tend to start there. | Cause is damaged vein valves, which lead to swelling when sitting or standing. Swelling damages the skin and causes wounds. |
| Treatment- Must improve the arterial blood flow to the toes either with minimally invasive balloons and stents or bypass surgery | Treatment- COMPRESSION, COMPRESSION, COMPRESSION These wounds will not heal without compression bandages such as a multilayer wrap, regardless of the wound products used on the wound |
| Good wound care after improving the blood flow will allow the wounds to heal | Evaluate veins with ultrasound and possibly inject dye in veins- sometimes can seal off a superficial vein or stent a narrow vein to help heal or prevent the wounds from reoccurring. |