Foot Care from A to Z

Thomas P. Lyman, BS; Tracey C. Vlahovic, DPM, FAPWCA

Disclosures

Dermatology Nursing 

In This Article

Ulcers

Ulcers come in various shapes and sizes on the lower extremity. Three main types are neuropathic, arterial, and venous. Ulcer care should generally include off-loading the area, converting the chronic wound to an acute, and providing a slightly moist environment to allow cellular migration. Neuropathic ulcers in diabetics are due to chronic repetitive trauma and/or friction on weight-bearing areas of the foot (Armstrong, Lavery, Vazquez, Nixon, & Boulton, 2002). The necrotic tissue commonly seen in and around these wounds should be debrided to encourage healing. Arterial ulcers occur near boney prominences and are due to a lack of blood supply. Revascularization commonly helps in the healing process; however, if the ulcer has already progressed to dry gangrene, revascularization aids in healing the subsequent amputation of the necrosed area. The typical venous ulcer will appear on the medial ankle and be preceded by itching and swelling. Compression of the ankle area aids in both pain control and closure (Baranoski & Ayello, 2008).

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