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Integumentary
Ulcer Characteristics
| Clinical Finding | Type of ulcer |
|---|---|
| Location on lower 1/3 of leg, toes, web spaces (distal toes, dorsal foot, lateral malleolus) | Arterial insufficiency |
| Smooth edges, well defined; lack granulation tissue; tend to be deep | Arterial insufficiency |
| Minimal exudate | Arterial insufficiency |
| Severe pain | Arterial insufficiency |
| Diminished or absent pulses | Arterial insufficiency |
| Normal edema | Arterial insufficiency |
| Decreased skin temperature | Arterial insufficiency |
| Thin and shiny tissue; hair loss; yellow nails | Arterial insufficiency |
| Leg elevation increases pain | Arterial insufficiency |
| Location proximal to the medial malleolus | Venous insufficiency |
| Irregular shape, shallow | Venous insufficiency |
| Moderate / heavy exudate | Venous insufficiency |
| Mild to moderate pain | Venous insufficiency |
| Normal pulses | Venous insufficiency |
| Increased edema | Venous insufficiency |
| Normal skin temperature | Venous insufficiency |
| Flaking, dry skin; brownish discoloration | Venous insufficiency |
| Leg elevation lessens pain | Venous insufficiency |
| Location on areas of foot susceptible to pressure of shear forces during weight bearing | Neuropathic |
| Well-defined oval or circle; callused rim; cracked periwound tissue; little to no wound bed necrosis with good granulation | Neuropathic |
| Low/moderate exudate | Neuropathic |
| No pain, however dysesthesia may be reported | Neuropathic |
| Diminished or absent pulses; unreliable ankle-brachial index with diabetes | Neuropathic |
| Normal edema | Neuropathic |
| Decreased skin temperature | Neuropathic |
| Dry, inelastic, shiny skin; decreased or absent sweat and oil production | Neuropathic |
| Loss of protective sensation | Neuropathic |
Created by:
glopez111
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