Figure 2.

Flowchart of the treatment for heel ulcers

First, examine the blood flow in the lower extremities to check if a patient with heel ulcer has PAD. Aggressive debridement with SPP of 40 mmHg or less owing to lower limb ischemia causes increased necrosis. Therefore, if lower limb ischemia is present, revascularization should be performed first. After successful revascularization, aggressive debridement should be performed. In addition, when vascular stenosis or occlusion occurred during treatment, revascularization treatment should be repeated again. In cases in which revascularization could not be performed, minimum debridement should be performed.