ABSTRACT
Wound healing is a complex and fundamental activity of all damaged body structures. The same principles underlie the healing of cuts, abrasions, ulcers and areas damaged by chemical attack, invasion by microorganisms or immune reactions. This chapter presents the common causes of persistent leg ulcers. Ulceration due to ischaemia is a common clinical problem, though less often seen than that due to venous hypertension. Atherosclerosis accounts for the majority of cases. Ischaemic ulcers are painful and irregular, occurring anywhere around the feet or lower legs. Neuropathic ulcers result from repeated, inadvertent injury to hypoanaesthetic or anaesthetic areas of skin subsequent to nerve injury. They are often deeply penetrating and often occur on the soles of the feet. Tuberculosis, tertiary syphilis and deep fungus infections can all result in persistent ulcers. Vasculitis, sickle cell disease and malignant disease are other causes of ulceration.
