There are several types of wounds, other than surgical or pressure related wounds, that are common in the clinical setting. These include (but are not limited to) arterial, venous, and diabetic ulcers. The following will briefly discuss ideas related to the specific cause, diagnostics, appearance, and treatment of an arterial wound etiology.
Arterial ulcers are caused by decreased blood flow to the lower extremity. Diagnostics to confirm this diagnosis include arteriograms,color duplex angiography, magnetic resonance arteriogram, arterial doppler, and transcutaneous oxygen monitoring. Treatment typically is achieved by improving the circulation with a bypass graft or angioplasty. Typically these wounds are very painful, so a silicone dressing like Mepitel or wound veil is a good choice for the primary dressing (if the wound is not infected). If the arterial wound consists of dry gangrene then betadine can be painted or Iodosorb ointment (Smith and Nephew) placed over the gangrenous tissue ( to keep the gangrenous tissue dry). There is a high risk for amputation in patients who are unable to be revascularized or if the gangrene converts to wet or gas gangrene.
Matthew Livingston R.N. C.W.S.