Wound diagnosis part 1b aterial leg wounds

risk factors ?

previous wound or amp

Charcot foot

DM with poor glycemic control

CKD

peripheral neuropathy

corns or callouses

ongoing smoking

what is the leg appearance?

thin, shiny, dry

hair loss on ankle or foot

dystrophic or yellow toenails

elevation pallor

dependent rubor

decreased temp

absent or diminished pulses

cyanosis

ischemic pain

what is the wound base?

pale or necroti

wound edges

well defined, punched outp

periwound

thin shiny

may be blanched or purpuric; hair loss and nail changes common

when should there be an arterial ultrasound?

if ABI < 0.6

what is apart of vascular testing

ABI

arterial ultrasound

toe brachial index if ABI > 1.4

what is the wound care ?

protect and offload

sharp debridement of nonviable tissue as indicated

appropriate dressings

for stable dry eschar apply povidone iodine and gauze

monitor for infection

control edema

when are referrals considered urgent gangreen in outpatient or non acute setting

ER if gangrene moist or worsening

gangrene in acute setting

notify physician ask to order arterial ultrasound and vascular surgery consult