Yesterday I posted a new pressure ulcer case report authored by Jenny Alderden, Dr. Tracey Yap and myself, which provides new evidence for the “inside out” vascular infarction theory of severe pressure ulcer formation (and which also explains Stage 1 pressure injuries). We are pointing out that angiosomal infarction is a better explanation for DTIs and severe pressure injuries. It is possible that the infarction begins on the venous side.
I mentioned this at a meeting some years ago, and a nurse asked me how it would be possible for occlusion of a vein to cause ischemia. By way of explanation, I posted this video some time ago about a venous infarction of the great toe. The patient had podiatric surgery, and the tourniquet that was applied to reduce bleeding was never removed. She gradually developed an infarction of the toe as a result of the occlusion of the digital VEIN.
Check out the Youtube video I made of her photos. I ask you, doesn’t this toe have the same appearance as a DTI or unstageable pressure ulcer?
Caroline
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
Venous infarction well described in the neuropathological literature, albeit having a somewhat different vasculature than the great toe. I believe CM Fisher & Phil Kistler wrote on this in the ’70’s, imsmc