Peripheral arterial disease (PAD) is a common circulatory problem that affects over 8.5 million U.S. adults and it has a 5 times higher mortality rate than leading cancers. Stemming from fatty build-up, or atherosclerosis, in the arteries, PAD causes blood vessels in the limbs to narrow. This can significantly reduce blood flow which can lead to a non-healing wound if an injury occurs. If left untreated, these wounds can become infected, and put patients at risk of sepsis, gangrene, or even amputation. 

Risk factors of developing PAD include aging, diabetes, obesity, and smoking. However, only around 25% of the population is aware of the disease, and many go undiagnosed. There are a variety of tests that may be used to identify PAD in your patients: 

• Ankle Brachial Index
• Toe Pressures
• Segmental Pressures
• Pulse Volume Recording
• Skin Perfusion Pressures
• Arterial Duplex Doppler
• Angiography

If a patient is presenting with a wound, a confirmed diagnosis of PAD provides a window through which a clinician can now view the entire cause of the wound. The most common wound types associated with PAD are Arterial, Venous, and Diabetic Foot Ulcers. 

• Arterial ulcers: Also referred to as ischemic ulcers, these are caused by damaged or blocked arteries which are unable to get nutrient-rich blood and oxygen to the lower extremities. This causes an ulcer or a break in the skin. Arterial ulcers are typically located on the foot or ankle.
• Diabetic neuropathic ulcers: Many patients with peripheral arterial disease also suffer from diabetes. Approximately 25 percent of individuals with diabetes will experience a non-healing open wound or diabetic ulcer caused by pressure or trauma on the lower limbs or feet. Because diabetic neuropathy causes a loss of sensation in the limbs, many patients don’t know they have an ulcer until it becomes infected.
• Venous ulcers: When patients have poor blood circulation in the legs, the blood can back up and “pool” in the veins, causing an ulcer. This can cause a painful open wound and edema, or swelling, on the ankles or lower leg.

With lifestyle changes and a commitment to treatment, PAD can be managed. Here are eight tips to share with your patients to encourage healing:

• Lose weight (if overweight) or maintain your current healthy weight
• Maintain a structured exercise program
• Eat a well-balanced, heart-healthy diet
• Control diabetes and high blood pressure

• Stop smoking
• Limit alcohol intake
• Avoid standing for long periods of time
• Wear compression wraps/stockings

About Wound Care Advantage

We Support Wound Centers. For over two decades, Wound Care Advantage (WCA) has supported wound centers to improve patient care and program profitability with innovative tools, technology, and services for sustained success. WCA's mission is to save patients' limbs and lives by promoting operational, clinical, and financial success in wound care programs across the country. For more information visit www.thewca.com.