Local blood pressure in chronic leg ulcers

The local arterial blood supply was evaluated according to clinical criteria in 30 consecutive patients with chronic leg ulcers. Separately, the blood pressure was measured at the ankle level with both strain gauge plethysmography and a Doppler ultrasonic method. In patients with clinical signs of arterial obliterative disease the systolic ankle pressure and the ankle/arm systolic pressure ratio were lower than in patients without such signs. In none of the patients was the local pressure decreased to such a degree that ischemia was the main cause of the ulcer, nor was gangrene imminent. Hence, success or failure of skin grafting or conservative treatment depends primarily on factors other than the nutritive flow, when the perfusion pressure is above 70 mmHg, as in the present study.