Non-healing arterial ulcers are wounds that do not heal properly because the skin and tissue are not receiving enough blood flow. They often occur on the toes, feet, heels, or lower legs and may be associated with PAD, diabetes, smoking, kidney disease, or severe vascular disease.
Because poor circulation can delay healing and increase infection or amputation risk, patients with persistent wounds should be evaluated promptly.
Symptoms patients may notice
- Open wound on the foot, toe, heel, or lower leg that is slow to heal
- Pain that may worsen when the leg is elevated
- Pale, blue, dark, or cool skin around the wound
- Drainage, redness, warmth, swelling, odor, fever, or signs of infection
- Known diabetes, PAD, or weak pulses
How we evaluate this condition
- Foot and wound examination
- Pulse exam, ABI testing, arterial Doppler ultrasound, or vascular imaging when appropriate
- Diabetes, infection, kidney disease, cholesterol, and smoking-risk review
- Coordination with wound care, podiatry, vascular surgery, or interventional teams when needed
Treatment and care options
- Circulation optimization, medication management, and risk-factor control
- Wound-care coordination, dressings, offloading, infection treatment, and debridement when appropriate
- Revascularization referral for angioplasty, stenting, atherectomy, or bypass when blood flow is inadequate
- Close follow-up to reduce infection and limb-risk complications
When to seek urgent care
Seek urgent care for rapidly spreading redness, fever, severe pain, black tissue, foul drainage, or sudden worsening of foot color or temperature.