Arterial Ulcer

Arterial ulcers result from an inadequate blood supply, which is almost always caused by atherosclerosis, or fatty plaque build-up in the arteries.  Cholesterol or other fatty plaques settle in the arteries, which then causes the arteries to narrow and harden from the build-up.  The narrowing and hardening of the arteries causes poor blood circulation.  If you have other underlying health conditions, such as diabetes and you get something as simple as a small scratch, it may not heal properly due to the compromised blood supply and could lead to the development of an ulcer.

You may hear arterial ulcers referred to as “ischemic ulcers.”  This means that once your arteries become clogged, blood flow and the supply of nutrients are inadequate which causes cells to die, which in turn damages the tissue creating an ulcer.  Generally, the damaged tissue does not get enough blood flow or an adequate supply of nutrients, which ultimately results in a slower treatment time.

Following are some signs, symptoms, and characteristics of an arterial ulcer:

o   Generally results in a full thickness wound.

o   Ulcer may or may not be painful.

o   If the leg is dangled off the side of a bed or chair, it will turn red.

o   If the leg is elevated it will turn pale and become cool to touch.

o   Client may complain of pain at night that is relieved by lowering the leg below the level of the heart.

o   Client may prefer to sleep in a chair, which negatively impacts healing of the ulcer.

o   Located mainly on outside or top of foot, but can occur anywhere on the lower leg or foot (legs, ankles, toes, and between toes).

o   Lower extremities are cool to touch.

o   Skin is pale, looks shiny and tight, and is also thin.

o   Skin around the wound area appears pale.

o   There will be minimal to no hair growth on the lower extremities.

o   Minimal drainage will be observed from an arterial ulcer.

Those with poor circulation are at risk for ischemic ulcers.  However, if you have diabetes, high blood pressure, kidney failure, or if you smoke, you may be at an increased risk for an ischemic ulcer.  Diseases that cause inflammation, such as lupus, may also increase your risk.  Plus, lymphedema may increase your risk.  Lymphedema causes fluid to build up in the legs which could compromise adequate blood flow, which could lead to ischemia of the affected area.

Treatment of arterial ulcers will be based on your current health condition, the severity of your ulcer(s), and also any underlying conditions will be taken into consideration when your provider develops your treatment regimen.  Following are a few goals that are generally followed for treatment of an arterial ulcer:

o   Providing adequate protection of the surface of the skin

o   Prevention of any new ulcers

o   Monitoring for signs and symptoms of infection

Prevention of arterial ulcers is also being focused on more clearly; following are some ways to reduce your risks of developing an arterial ulcer:

o   Quit smoking.

o   Manage your blood pressure.

o   Take control of your cholesterol levels by making any necessary diet changes and take all medications as prescribed.

o   Limit intake of sodium.

o   Manage any other health conditions you may be faced with, such as diabetes.

o   Maintain a regular exercise regimen; even if you walk for 30 minutes a day, every little bit counts.

o   If you are overweight, work toward losing the excess pounds.

o   Take time to observe your legs and feet daily for any changes in your skin, because if you have a disease that causes neuropathy it may compromise your sense of feeling.

o   Wear shoes and socks that properly fit and do not walk barefoot.

o   Avoid crossing your legs while sitting, and try not to sit or stand in one position for too long.

o   Protect your feet from cold temperatures.

o   Do not wear compression stockings or wraps unless told to do so by your physician, as they could restrict blood flow.

As always, never hesitate to contact your provider with any changes you notice to your body.  The quicker you begin to follow a treatment plan, the better your prognosis with your condition will be and the less likely your lifestyle will be compromised.  Total Home Health has a program that is right for you.  Our professional staff is ready to participate in your plan of care and assist you with any or all parts of your treatment plan that your provider suggests for your arterial ulcer.