title: Arterial disease ulcers, part 1: clinical diagnosis and investigation.
abstract: Arterial disease (peripheral vascular disease) is the result of narrowing of the blood vessel lumen. The classic clinical signs need to be recognized early before progression to arterial predominant disease and limb ischemia. Arterial ulcers or tissue breakdown can result from trauma, infection, or other etiologies with diabetes, smoking, increasing age, and hypertension the most important risk factors. Diagnostic testing starts with a palpable pulse with special investigation including handheld Doppler for ankle brachial pressure index ratios, segmental duplex leg Doppler waveforms, and more specialized procedures, including transcutaneous oxygen saturation.
authors.affiliation: Gregory Ralph Weir, MBChB, MMed(Surg), Certificate in Vascular Surgery, IIWCC (ZA) • Medical Director • Vascular and Hyperbaric Unit, Life Eugene Marais Hospital • Pretoria, South Africa Hiske Smart, MA, RN, PG Dip(UK), IIWCC (Toronto) • Nurse Manager • Wound Care and Hyperbaric Oxygen Therapy, King Hamad University Hospital • Muharraq Island, Kingdom of Bahrain• Jacobus van Marle, MBChB, MMEd(Surg) • Consultant Vascular Surgeon • Medical University of South Africa • Pretoria, South Africa Frans Johannes Cronje, MBChB(UP), BSc(Hons), MSc • Associate Medical Director • Baromedical Facility, Tygerberg Hospital • Western Provence, Cape Town, South Africa.
authors.forename: Gregory Ralph
authors.initials: GR
authors.lastname: Weir
authors.forename: Hiske
authors.initials: H
authors.lastname: Smart
authors.forename: Jacobus
authors.initials: J
authors.lastname: van Marle
authors.forename: Frans Johannes
authors.initials: FJ
authors.lastname: Cronje
mesh_terms: D001785:Blood Gas Monitoring, Transcutaneous / Q000379:methods; D006801:Humans; D007511:Ischemia / Q000150:complications; D017078:Laser-Doppler Flowmetry / Q000379:methods; D007866:Leg / Q000098:blood supply; D007871:Leg Ulcer / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D010173:Palpation; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis*; D012307:Risk Factors