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Arterial disease ulcers, part 1: clinical diagnosis and investigation
Gregory Ralph Weir1, Hiske Smart, Jacobus van Marle
1Gregory Ralph Weir, MBChB, MMed(Surg), Certificate in Vascular Surgery, IIWCC (ZA) • Medical Director • Vascular and Hyperbaric Unit, Life Eugene Marais Hospital • Pretoria, South Africa Hiske Smart, MA, RN, PG Dip(UK), IIWCC (Toronto) • Nurse Manager • Wound Care and Hyperbaric Oxygen Therapy, King Hamad University Hospital • Muharraq Island, Kingdom of Bahrain• Jacobus van Marle, MBChB, MMEd(Surg) • Consultant Vascular Surgeon • Medical University of South Africa • Pretoria, South Africa Frans Johannes Cronje, MBChB(UP), BSc(Hons), MSc • Associate Medical Director • Baromedical Facility, Tygerberg Hospital • Western Provence, Cape Town, South Africa.
Abstract:
Arterial disease (peripheral vascular disease) is the result of narrowing of the blood vessel lumen. The classic clinical signs need to be recognized early before progression to arterial predominant disease and limb ischemia. Arterial ulcers or tissue breakdown can result from trauma, infection, or other etiologies with diabetes, smoking, increasing age, and hypertension the most important risk factors. Diagnostic testing starts with a palpable pulse with special investigation including handheld Doppler for ankle brachial pressure index ratios, segmental duplex leg Doppler waveforms, and more specialized procedures, including transcutaneous oxygen saturation.
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