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Role of Ankle Brachial Index (ABI) in Management of Non-Healing Ulcers of Lower Limb

Background: Chronic leg ulcers (CLU) are difficult to heal. Along with history and clinical examination, the ankle brachial index (ABI) is a simple, noninvasive tool used to screen peripheral arterial disease (PAD).
Objective: This study sought to evaluate the association between abnormal ABI and clinical outcomes in patients with lower limb ulcers. Material and Methods: It was a prospective study involving 50 patients with mean age of 47 years having chronic ulcer/ulcers in lower limb. ABI was calculated for bilateral lower limbs.
Results and Conclusions: CLU with vascular etiology accounted for 84% of all chronic ulcers. Maximum ulcers (52%) were due to arterial insufficiency. Mean value of ABI of diseased (limb with ulcer) limb was 0.96 (max=1.2 and min=0.45) and ABI of normal (limb without ulcer) limb was 0.94 (max=1.2 and min=0.8). It was statistically insignificant. ABI value of 0.9 indicates possible borderline PAD. Mean ABI value of diseased limb was 0.94 and it was significantly associated with smoking; (P-value<0.05). Out of 50 patients, 42 patients (84%) had ABI value >0.90 and 7 patients (14%) had ABI value <0.90. ABI value less than 0.9 was associated with poor wound healing and recurrence of ulcers. Hence, ABI is a safe and reliable method of screening of PAD. All patients with an ABI of less than 0.8 should be referred for specialist assessment.


Mukta Verma*, Arun K Singh, Vijay Kumar and Brijesh Mishra

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