skip to main content

Ischaemic heel pressure ulcer with cellulitis — SCE Geriatric Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardTissue viabilityIschaemic heel pressure ulcer with cellulitisSCE Geriatric Medicine

An 82-year-old woman with long-standing diabetes and peripheral arterial disease has a heel pressure ulcer after two weeks in hospital. The wound has black eschar, surrounding cellulitis and an ABPI of 0.55; CRP is 98 mg/L and foot pulses are absent. What is the most important next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Urgent vascular and tissue viability assessment with treatment of infection and pressure offloading

The low ABPI and absent pulses suggest significant arterial disease, so vascular assessment is essential before debridement or compression. Cellulitis also requires systemic infection management and pressure offloading. Compression would be unsafe with this ABPI, and topical therapy alone is inadequate. The pearl is that pressure ulcers in older adults often reflect combined pressure, perfusion, nutrition and infection problems.

Reference: NICE CG179; NICE NG19; JRCPTB geriatric curriculum