Question

A patient presents to the clinic with a painful wound. The characteristics of the wound are punched out margins over the dorsal aspect of the foot. The base of the wound looks pale and necrotic and lacks granulated tissue. When the extremity is lowered following elevation, the skin turns a dark red after 50 seconds. Which of the following interventions is LEAST appropriate at this time?

a. Compression to have a pumping effect for improving blood flow
b. Educating the patient about his condition and appropriate wound care at home
c. A supervised walking program
d. Elevation of the extremity until blanching followed by lowering of the feet

Answer 1

The characteristics of the wound suggest arterial insufficiency. The LEAST appropriate intervention would be elevation of the extremity until blanching followed by lowering of the feet.

Step-by-step explanation:

The characteristics of the wound described suggest a condition called arterial insufficiency, which occurs when there is inadequate blood flow to the lower extremities. The pale and necrotic base of the wound, lack of granulated tissue, and delayed capillary refill time (skin turning dark red after 50 seconds) all indicate poor circulation. Based on this information, the LEAST appropriate intervention at this time would be d. Elevation of the extremity until blanching followed by lowering of the feet. This technique, known as dependent rubor, is typically used to assess arterial flow by observing the color change in the skin after elevation. However, in this case, the wound already shows signs of poor circulation, and further elevation may worsen the condition.