Assessment includes noting the color and temperature of the skin in the affected areas and any signs of trophic changes. Epidermoid tissues that are chronically malnourished because of poor blood supply appear shiny, smooth, and thin, with little or no hair on the surface. The nails are thick, with deposits of cornlike material under them. With time, a decreased blood supply produces ischemic changes that cause the skin to assume a purple-black color that is characteristic of cyanosis and gangrene. Additional assessment data include the rate, rhythm, and force of the peripheral pulses.
Chronic edema can lead to ulceration.
Venous insufficiency also produces a darkened color, dryness, and scaling of the skin in the affected areas. Venography, a radiologic test in which the vein is injected with a radiopaque dye prior to filming, can also demonstrate engorged and tortuous veins. In order to prevent or mitigate the effects of arterial insufficiency or venous stasis, patients must be taught techniques of self-care. All rights reserved.