Identification of Lower Extremity Ulcers, Evaluation and Treatment

The purpose of this paper is not to make primary care physician assistant’s experts in the evaluation and treatment of lower extremity ulcers but to help guide you in the initial evaluation and work up of ulcers. Identifying the type of ulcer is important to ensure proper treatment for example mixed arteriovenous leg ulcers were associated with lower health related quality of life, greater mobility impairments, and more deficits in self-care and usual activities. 1 Lower extremity ulcerations are seen commonly in patients with peripheral arterial and venous disease in cardiovascular practice. The recognized risk factors include tobacco use, hypertension, hyperlipidemia and diabetes for peripheral arterial disease and venous insufficiency and deep vein thrombosis in venous disease. The need to properly identify and diagnose the ulcers placing them in the correct category is imperative as the proper treatment can mean the difference between a healing ulcer or possible amputation of the affected limb. This review will cover the diagnosis and treatment of various lower extremity ulcers. Even with the best available care, at least 25% of leg ulcers and foot ulcers are not fully healed after 6 months of treatment.