When an individual does not receive proper blood flow or oxygen to areas such as the feet or legs, arterial insufficiency ulcers may form. These are usually caused because of blocked arteries, often associated with atherosclerosis, also known as a hardening of the arteries.
“An ulcer may occur at the advanced stage of the disease when there is so little blood flow that the skin breaks down,” explains Avrohm Faber, M.D., author of a recent Daytona Beach News-Journal article. “This usually occurs on the toes, or the end of the foot — the part of the body farthest from the heart. This type of wound is a real danger signal, for it indicates that the limb is in jeopardy of being lost. These wounds are usually painful.”
Dr. Faber continues his article by explaining that wounds found on the foot or leg are often the result of an injury that doesn’t heal quickly, like cuts, scrapes or insect bites. If the wound worsens or becomes infected, it is sometimes due to a medical impairment that interferes with proper healing, such as poor circulation.
In cases where arterial blockage is suspected, diagnostic studies must be carried out. These can include ultrasound studies, Doppler studies and angiography, where images of the arteries are taken. In some cases, patients may receive a consultation with a vascular specialist.
“If treatment is required to open blocked arteries, nonsurgical methods may be utilized using catheters inserted into the arteries to remove plaque (cholesterol and calcium deposits), expanding the diameter of the vessel (balloon angioplasty), or placing metal stents to keep the artery open,” says Dr. Faber. “If feasible, blood clots can be dissolved with medicine infused through a catheter. In cases where the catheter technique is not possible or when the anatomic situation requires it, surgery may be the preferred approach. This would mean bypass grafting, plaque removal or a combination of techniques.”
Once adequate blood flow has been restored, Dr. Faber explains that appropriate wound care measures can resume. He concludes that at this point in the process, patients often have a good chance of fully healing.
