Wound in lower limb are common and have tendency to turn chronic. There are basically 3 types of ulcers which can present in the lower limb. They are venous stasis ulcers, arterial or ischemic ulcers and neuropathic or diabetic ulcers. It is important to identify the type of wound because management and prognosis are different for different types of wound. Venous stasis ulcers are mainly located below the knee and in the inner aspects of the leg just above the ankle, like the medial malleolus (Gabriel and Camp, 2008). They occur when inadequate action of the calf muscle to pump out blood results in venous hypertension (Gabriel and Camp, 2008). The base of the ulcer is usually red, the borders are irregular and the ulcer may be covered with yellowish tissue. Fluid drainage is a characteristic feature of venous ulcer. The surrounding skin will be discolored and swollen and may feel warm (Gabriel and Camp, 2008). Ischemic or arterial ulcers are usually located in the feet, especially in regions where there is friction between toes or parts of feet with shoes, or when there is a deformity. They are more likely to occur in the periphery where there is decreased blood supply. The ulcer base is yellowish, grey or black and does not bleed (Gabriel and Camp, 2008). The borders are initially irregular and later have a regular appearance. Neuropathic ulcers commonly occur in diabetic patients and they are usually located at pressure points on the plantar aspect of the feet. Neuropathy causes loss of foot sensation and also changes in sweat-producing glands increasing the risk of being unaware of foot trauma, injuries and callosities. The ulcers appear punched out with the surrounding skin callosed. The ulcer may appear pink or brown (Gabriel and Camp, 2008).
Lower extremity ulcers have varied prognosis and are associated with many complications. They are the