'It hurts so much, I can't walk!' Arterial ulcers--etiology and assessment.

摘要

I once had a patient with an arterial ulcer so painful, he would not allow anyone to touch the wound unless he was sedated. He not only had pain when the wound was being manipulated, the pain would wake him up in the middle of the night And, forget walking...he used a wheelchair. Approximately 8% to 10% of patients with perfusion problems in the lower extremities have arterial insufficiency (Young, 1983). Arterial perfusion depends upon cardiac performance. Conditions affecting blood viscosity and velocity, such as dehydration, atherosclerosis, and polycythemia will decrease arterial perfusion. In some instances of dehydration, rehydration can reduce red blood cell mass and increase perfusion. The deformability of the red blood cell also plays a role in perfusion. Conditions that make red blood cell (RBC) membranes more rigid increase transit time in the smaller arterioles and decrease tissue perfusion.