Approach to a Case of Ulcer of Lower Extremity

Abstract

Treatment of a wound of lower extremity is not a simple course, and one type of treatment does not fit for all patients. So the first step should be to find out the underlying pathology. There are several causes for the ulcers of the lower extremity. Basically they may be traumatic, inflammatory, neoplastic, or vascular causes and autoimmune causes. The common causes are venous, arterial, diabetic, and neuropathic ulcers. Other causes are shown in Table 1. The goal of treatment in any case of ulcer is to heal the wound, relieve the pain, regain a high quality of life, and prevent the recurrence. So treatment of chronic wound requires the multidisciplinary and comprehensive approach for salvage of the limb. This may require vascular physicians, vascular surgeons, cardiologist, podiatrist, endocrinologist, plastic surgeons, infectious disease specialist, dermatologist, oncologist, orthopedic surgeon, and rehabilitation personnel and dedicated nursing staff. It needs an individualized wound care protocols with the goal of special recovery. It may involve advanced technologies for diagnosis and treatment, topical wound care dressing and therapies, antibiotics, antiplatelet drugs, compression garments, intervention to improve circulation, and prosthetics. The patient’s active participation in healing of wound is well appreciated in terms of keeping the wound clean and dry, changing the dressing as per need, taking prescribed medicines, healthy diet, regular exercises, and wearing compression stockings and shoes as prescribed. Basically the patients are advised to avoid smoking; take proper diet; control sugar, blood pressure, and cholesterol; and lose weight if overweight [1].