Dr. Blume took part in a point-counterpoint debate with other podiatrists in the magazine Podiatry Today. The topic was: Is Ischemia A Direct Risk Factor For Ulceration?

From the conclusion:

Numerous ulcers occur because of inadequate perfusion of skin and subcutaneous tissue at rest. Arterial occlusive disease, which is common among smokers, patients with diabetes and the elderly, can lead to claudication, rest pain and gangrene in addition to localized ulceration. Other processes, such as venous stasis, pressure, trauma and vasculitis, can also cause ischemia.

However, a thorough patient history and physical assessment can help discriminate between ischemic ulcers caused by arterial disease and other types of ulcers. The key to the diagnosis of arterial occlusive disease is the patient history. Pain while walking is the most common presenting complaint and can indicate intermittent claudication. The physical assessment should include a focused exam of the affected extremities and arterial pulses. Vascular laboratory findings can also help confirm a diagnosis of arterial ischemic ulceration.

The key to treatment is improving the vascular perfusion to the affected area. Surgical revascularization is the mainstay of treatment with some interventional procedures becoming accepted. In addition to correcting underlying medical problems, treatment options should facilitate good wound and supportive care. When an adequate blood supply has been re-established, most arterial ulcers will progress to healing unless there are complicating factors.

You can find the entire article here.

About the Author

Affiliated Foot and Ankle Surgeons

Affiliated Foot and Ankle Surgeons are foot and ankle surgeons in New Haven, Connecticut. They provide the best podiatric care to patients with foot and ankle problems. Dr. Peter Blume and Dr. Farlyn Charlot-Hicks are Connecticut's best foot and ankle surgeons. You can contact them at (203) 397-0624.