Base

The base of an ulcer usually consists of granulation tissue or slough. Sometimes the floor of the ulcer will provide extra information about the nature of the ulcer:

• wash-leather appearance is seen in syphilitic ulcers
• bluish unhealthy granulation tissue seen in tuberculosis ulcers
• no granulation tissue is often present in ischaemic ulcers - in this case structures such as tendons may lie bear in the base of the ulcer
• solid brown or grey dead tissue suggests full-thickness skin death
• the redness of the granulation tissue is proportional to the underlying vascularity of the ulcer site (and therefore of the ulcer's ability to heal)

Reference

1. De Maeseneer MG et al. European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs. Eur J Vasc Endovasc Surg. 2022 Feb;63(2):184-267.