Lower-extremity ulcers: diagnosis and management

Summary Chronic wounds of the lower extremities are occurring with increasing prevalence. They affect millions of individuals annually, representing both a significant health risk and a large economic burden. Chronic wounds are associated with increased mortality and substantial morbidity due to infection, pain, limitation of daily activities, and psychosocial consequences. To manage these wounds effectively, clinicians must be able to diagnose and manage their aetiology. Diagnosis starts with determining whether the wound is one of the four most common chronic wounds: venous leg ulcers, diabetic foot ulcers, pressure ulcers and arterial ulcers. Moreover, despite many recent advances in wound care, the challenge of managing chronic wounds is complicated by the lack of consistently accepted diagnostic methods and wound‐care standards. We present a comprehensive yet condensed approach to managing lower‐extremity ulcers, from diagnosis to basic management. What's already known about this topic? Increasing in prevalence, the 4 most common chronic wounds are diabetic foot ulcers, venous leg ulcers, pressure ulcers and arterial ulcers. These wounds represent a significant socioeconomic burden due to the high cost of wound care, long time to heal, morbidity, high complication rate and impact on patients' and relatives' quality of life. Part of the problem is that non‐specialized care providers lack familiarity and consistency in the use of standardized diagnostic methods and treatment strategies. What does this study add? Non‐specialized care providers, including dermatologists should have a strong knowledge foundation on these common chronic wounds to increase diagnostic accuracy and implementation of standard of care methods. This review presents a comprehensive, complete review from the diagnosis and pathophysiology to the differential diagnosis and standard of care treatment of these ulcers.