Ischaemic Leg Ulcer

In this chapter, nine cases are presented to describe the typical development of ischaemic leg ulcers focusing on the key point in diagnostics and treatment. The cases are selected to illustrate the importance of a holistic approach combined with a multidisciplinary set-up. Quick identification of a potential ischaemic component to a chronic wound is essential. The diagnosis of ischaemic leg ulcers is based on clinical characteristics combined with an objective and physical examination of the patient. Peripheral pulse palpation and measurement of the ankle brachial index (ABI) are first-line non-invasive hemodynamic screening for assessing the severity of the peripheral arterial disease (universal atherosclerosis, obstructing the circulation to the lower limbs leading to decreased oxygen inflow by which cell division and tissue survival are compromised and rest pain, necrosis and/or gangrene arise). Furthermore, aggressive local wound treatment both before and after revascularization is essential.