What is an Ischemic Ulcer?

An ischemic ulcer is a break in the integrity of the skin, which appears as open wounds or lesions brought about by a significant reduction of blood supply to the area. A decrease in the amount of blood going to a specific organ of the body consequently reduces its oxygen supply. Oxygen is very important in the normal functioning of cells, and without oxygen, cell death can occur. The most common sites of the body affected by an ischemic ulcer are usually the legs and the feet.

There are several medical conditions that can precipitate the formation of ischemic ulcers. People with conditions such as atherosclerosis, which is the hardening and narrowing a blood vessel, and those with poorly functioning valves in the veins have relatively greater chances of developing ischemic ulcers. Diabetes may also predispose individuals to develop diabetic ulcers or foot ulcers. Heavy smokers and genetically predisposed individuals are also considered to be at risk.

The cause of an ischemic ulcer is basically the inability of oxygen-rich blood to reach certain parts of the body. In patients with arterial insufficiency or problems in the arteries of the legs, for example, blood circulation in the affected leg is greatly compromised. Cells, tissues, and muscles in the lower extremities are deprived of oxygen, leading to cell death. The resulting death of cells will manifest as an open wound, which may be very slow to heal or will not heal at all, because there is no oxygen to help with the healing process.

Initial symptoms of a developing ischemic ulcer often include swelling, reddish skin discoloration, and appearance of dry scaly skin, with numbness or tingling sensation felt in the affected area. Pain may or may not accompany an ischemic ulcer. As the deprivation of oxygen continues, the ability of the patient to feel pressure, pain, and temperature is usually decreased, rendering the area sensation-less. Often the patient comes to the doctor with these complaints and the doctor makes the diagnosis based on these manifestations.

Management and treatment of patients often requires treating the underlying medical conditions causing the ischemic ulcer. Patients are then taught how to properly clean the wound by washing with mild soap and water in order to prevent infection from setting in. Other recommended practices for patients with ischemic ulcers are using soft, comfortable footwear, not going barefoot, and frequently inspecting the affected area.