Arterial & Mixed Ulcers
Arterial ulcers form when not enough blood reaches the legs and feet. We protect the wound at home or in your facility and work closely with your doctor and vascular specialist.
What is it?
An arterial ulcer is a wound caused by poor blood flow in the arteries. It often forms on the toes, the heel, the top of the foot or the outer ankle. These wounds tend to look round and “punched out,” and they are often painful.
The most common cause is peripheral artery disease (PAD). Fatty buildup narrows the arteries, so the skin does not get enough oxygen to stay healthy or heal. Pain may get worse at night or when the legs are raised, and ease when the legs hang down.
A mixed ulcer has both artery and vein problems. Treatment depends on how much blood is reaching the leg. Getting blood flow checked, and improved when possible, is often the key to healing. Procedures to open arteries are done by vascular specialists, and we help coordinate that care.
Causes & risk factors
Why it happens
- Peripheral artery disease (narrowed or blocked leg arteries)
- Smoking or past smoking
- Diabetes
- High blood pressure and high cholesterol
- Older age and kidney disease
- A minor bump or pressure from shoes on a foot with poor blood flow
How we help
How we treat it where you live
- Check pulses, skin color and temperature at each visit and track any changes
- Keep the wound clean, protected and dry or moist as the plan calls for
- Use gentle care, since some treatments, like strong compression or aggressive debridement, may not be safe with poor blood flow
- Protect the feet and heels from pressure and injury
- Send progress notes to your doctor and help coordinate a vascular specialist visit when needed
Treatments
Treatments used for arterial & mixed ulcers
Your physician orders the treatment. We match it to the wound and adjust it at every visit.
Wound Assessment & Measurement
A careful check of the wound at every visit, so we can see what is working and keep your doctor informed.
Learn moreAdvanced Wound Dressings
Modern dressings matched to your wound to manage moisture, protect the skin and fight infection.
Learn moreOffloading & Pressure Relief
Taking pressure off a wound with special boots, shoes, cushions, mattresses and repositioning.
Learn morePatient & Caregiver Education
Clear, hands-on teaching so patients, families and facility staff can care for the wound between visits.
Learn morePrevention
Helping it heal, and keeping it from coming back
- Stop smoking. This is one of the most helpful things you can do for blood flow.
- Take your medicines for blood pressure, cholesterol and blood sugar as prescribed.
- Walk as your doctor advises to help build blood flow.
- Wear soft, well-fitting shoes and never walk barefoot.
- Check your feet every day for color changes, sores or cuts.
- Do not use heating pads or hot water bottles on your feet.
Get help right away if you notice
- A foot or leg that suddenly turns cold, pale, blue or numb (call 911)
- Sudden, severe leg or foot pain that does not go away
- Skin or toes turning black
- Fever, spreading redness or a strong bad smell from the wound
For a medical emergency, call 911 or go to the nearest emergency room.
Questions
Arterial & Mixed Ulcers: common questions
Why does my wound hurt more at night?
When you lie flat, gravity helps blood flow to your feet less. This can cause more pain in a foot with poor blood flow. Tell your doctor about this pain, since it can be a sign the arteries need to be checked.
Can you fix my blood flow?
Tests and procedures to improve blood flow are done by vascular specialists. We do not perform them. We care for the wound, track changes and help coordinate your visit with a specialist.
Should I use compression for an arterial ulcer?
Strong compression can be dangerous when blood flow is poor. For some mixed ulcers, a specialist may order lighter compression after blood flow is tested. Never use compression on these wounds unless your doctor orders it.
Should I soak my feet?
No. Soaking can soften the skin and raise the risk of infection. Hot water can also burn skin you may not be able to feel well. Follow the cleaning steps your care team gives you.
Ready to get a wound looked at?
Tell us about the wound and we will call you to schedule a visit at home or at the facility. Physicians and facilities can send a referral online or by fax.