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Arterial vs. Venous Ulcers
By Bryan C. Kramer, MD - February 24, 2020
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.