Arterial ulceration is due to a reduced arterial blood supply to the lower limb.
Table 6.
| Venous | Arterial | |
|---|---|---|
| Wound bed | Often covered with slough | Often covered with varying degrees of slough and necrotic tissue |
| Exudate level | Usually high | Usually low |
What are the characteristics of an arterial ulcer?
Arterial ulcers are characterized by a punched-out look, usually round in shape, with well-defined, even wound margins. Arterial ulcers are often found between or on the tips of the toes, on the heels, on the outer ankle, or where there is pressure from walking or footwear.
How can you distinguish between an arterial ulcer and a venous ulcer?
Venous ulcers most commonly occur above the medial or lateral malleoli. Arterial ulcers often affect the toes or shin or occur over pressure points. Neuropathic ulcers tend to occur on the sole of the foot or over pressure points.
Do arterial ulcers have exudate?
Arterial ulcers are most commonly located at the points farthest from the heart (toes, forefoot) and classically have well-defined margins, a pale or necrotic wound bed, and minimal to no exudate.
Do venous ulcers have Slough?
Venous leg ulcers can commonly manifest with slough. Removing non-viable or desiccated tissue helps allow healthy tissue to grow. Slough in this common wound type can be treated with various forms of debridement. Mechanical debridement can be performed while cleansing the wound bed.
What are the associated physical findings of an arterial ulcer?
Distinguishing features of arterial ulcers include: Located on the lower legs and tops of the feet or toes. A tendency to be painful, particularly at night. A symmetrical shape with well-defined borders, often described as having a ‘punched-out appearance’
What are five indications for arterial lines?
Indications for arterial cannulation include but are not limited to:
- Continuous blood pressure monitoring.
- Continuous mean arterial pressure monitoring.
- Frequent arterial blood gas specimens.
- Frequent blood sampling for diagnostic testing.
Do arterial ulcers have drainage?
Characteristics of Arterial or Ischemic Ulcers Can Include:
Skin that is cool or cold to the touch. Minimum drainage from the wound. A round wound with even edges or the look of being punched out.
What does an arterial leg ulcer look like?
Arterial ulcers have a distinct “punched out” appearance and are typically circular with a red, yellow, or black coloration. They are usually extremely painful. Venous ulcers are often painless unless they are infected.
Are arterial wounds wet or dry?
The wound base typically is pale, dry, necrotic, and without granulation tissue (see photograph of an arterial ulcer on the foot).
Is slough and exudate the same?
Slough refers to the yellow/white material in the wound bed; it is usually wet, but can be dry. It generally has a soft texture. It can be thick and adhered to the wound bed, present as a thin coating, or patchy over the surface of the wound (Figure 3). It consists of dead cells that accumulate in the wound exudate.
Should you Debride an arterial ulcer?
It is not appropriate to debride arterial ulcers as this may promote further ischaemia and lead to the formation of a larger ulcer. Choice of wound dressings will be dictated by the nature of the wound. Vasoconstrictive drugs such as non-selective β blockers should be avoided.
How do you distinguish between arterial and venous insufficiency?
Both arterial and venous insufficiency share many of the same symptoms and characteristics, but they are actually quite different. Poor circulation in the arteries causes arterial insufficiency, while venous insufficiency occurs when blood flows poorly through the veins.
What stage wound has Slough?
Slough is present only in stage 3 pressure injuries and higher. Slough may be present in other types of wounds such as vascular, diabetic, among others.
What stage pressure ulcer have Slough?
Category/Stage 4: Full thickness tissue loss
Slough or eschar may be present. Often includes undermining and tunneling. The depth of a Category/Stage IV pressure ulcer varies by anatomical location.
What stage is a wound with Slough?
Slough is considered the by-product of the inflammatory phase of wound healing.
Do arterial ulcers have granulation?
Arterial ulcers
Initially they have irregular edges, but they may progress to have a better-defined appearance. The ulcer base contains grayish, unhealthy-appearing granulation tissue.
What are two characteristics of arterial insufficiency?
Common symptoms of arterial insufficiency
Peripheral arterial insufficiency often leads to pain, aching, numbness or cramping in the arms or legs. Symptoms related to the arteries of the heart include: Chest pain or pressure. Difficulty breathing or rapid breathing (tachypnea)
How do you assess an arterial ulcer?
Ankle-brachial index (ABI) is used to measure peripheral tissue perfusion. When pulses are difficult to palpate, Doppler ultrasound can be used. Diagnosis of an arterial ulcer is made through a combination of the patient’s history, appearance and characteristics of the wound and the ABI results.
Why is saline used for arterial lines?
Heparinized saline solution is used to prevent occlusion in the arterial catheters and central venous pressure monitoring catheters. Even at low dose, heparin administration can be associated with serious complications.
Can a nurse place an arterial line?
It is not within the scope of practice of a licensed practical nurse (LPN) to place arterial lines for monitoring and sampling purposes.