Lower limb ulcers including nonhealing postoperative wounds are challenging problems, especially to orthopedic surgeons. Such ulcers are recognized complications of rheumatoid arthritis but the scenario has changed for the better since the advent of aggressive disease-modifying antirheumatic drugs (DMARDs). Out of different types of lower limb ulcerations including venous, arterial, lymphatic, malignancies, infection, medication induced and inflammatory, autoimmune inflammatory conditions need to be delineated. They can be improved, though slowly with DMARDs. The pathogenesis is multifactorial but most prevalent are vasculitis. The various investigative tools for diagnosing the causes of these ulcers include plethysmography, ultrasound, angiography, computed tomography, magnetic resonance imaging, chromosomal analysis, and, most importantly, skin biopsy. Clinical presentation of the patient still remains the supreme disease tracker. Review of the literature is presented to ascertain the evidence for best clinical practice.
Keywords: Disease-modifying antirheumatic drugs, Immunomodulators, Immunosupressants, Infection, Limb ulcers, Pain, Rheumatoid arthritis, Vasculitis.
How to cite this article: Jha SS. Lower Limb Refractory Ulcers and Postoperative Nonhealing Wound: Review of the Literature. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):10-13.
Source of support: Nil
Conflict of interest: None