You’re going about your daily routine, cleaning the house and getting ready to see a friend later in the day when you notice a nagging pain again in your calves. Like usual, you ignore the discomfort and chalk it up to “just getting older” or “wearing the wrong shoes”. You get dressed, put a small bandage on this leg wound that does not heal and head over to see your friend at your favorite lunch spot. The sore begins to throb in the car on the way over making it painful to drive the car, but you push it out of your mind.
While enjoying lunch with your friend you mention you’ve had this cut that won’t heal for a few months. You never thought much of it in the past, but your friend tells you to go see a doctor immediately just to be sure. A few weeks later when you see your doctor, they examine your wound that’s not healing and are concerned it could be caused by a vascular condition known as peripheral artery disease (PAD).
“Surprisingly, slow-healing leg wounds are fairly common, especially as you age,” reveals Dr. Yan Katsnelson.
In fact, around 5% of people over the age of 65 will experience slow or non-healing open wounds on their legs. Additionally, over 30% of all slow-healing sores on the legs are caused by underlying arterial issues like PAD.
Are They Cuts, Sores, Ulcers, or Slow-Healing Wounds?
It can often be difficult to know if your wound that’s not healing is just a cut, a sore, an ulcer, or a peripheral vascular disease wound. Most slow-healing wounds on legs, ankles, or feet are being caused by an underlying issue, not just age. The best way to know if it’s just a cut you shouldn’t worry about compared to a peripheral vascular disease wound, is to track its progress. Write down or take pictures of your wound and any changes you may experience over a few weeks. Always make sure to consult your physician if your wound gets larger, deeper, starts to leak fluids, swells, or is painful. Here are a few things to do when you notice a cut not healing:
- Call your doctor and report your symptoms and level of discomfort
- Cover any leg wounds that do not heal and let it breathe for a few hours each day
- Wear loose fitting clothing and comfortable shoes
- Administer antibacterial ointment at least once a day
- Keep your slow-healing sores clean at all times
- Track its progress and report all changes to your physician
- Consult a vascular specialist if you think an arterial disease like PAD could be the cause
Even as you age and your body stops producing new cells as quickly as you once did when you were younger, long-term unhealed wounds on legs are not normal. Additionally, you should see a scab forming a little over or under a week. If your cut, sore, ulcer, or wound hasn’t completely healed in two to four weeks, you need to reach out to your doctor.
It’s important to rule out any underlying causes of slow healing cuts so you can get to the bottom of why your leg wounds do not heal. Thankfully, there are a few causes and risk factors that you should be aware of so you can be proactive about your vascular health.
Slow-Healing Wounds: Causes and Risk Factors
If you’ve noticed slow-healing sores or wounds on the legs, ankles, or feet, you may be concerned that there is an underlying issue. Some causes of slow or non-healing wounds include:
- Autoimmune infection or other immune system issues
- Poor nutrition
- Living a sedentary life
- Repetitive Trauma
- Vein disease and poor circulation
- Peripheral Artery Disease (PAD)
How Does Peripheral Artery Disease Cause Slow-Healing Wounds?
Peripheral artery disease, the accumulation of plaque within the arteries, affects the lower extremities by causing painful symptoms such as leg pain, muscle cramps, difficulty climbing stairs, poor toenail or leg hair growth, restlessness at night, skin color changes, etc. PAD often causes non or slow-healing wounds on the legs, ankles, or feet because vital oxygen and nutrients are not successfully reaching your extremities. If your plaque buildup is too severe, the blockage causes your legs to have poor circulation, which is crucial for wound healing.
Additionally, if your wound is infected, PAD can prevent the delivery of antibiotics. Therefore, you could be actively treating your slow-healing sore or wound with antibiotics, but it may not be reaching the correct areas. That is why many peripheral vascular disease wounds tend to go unhealed, which can cause a myriad of complications.
Diabetes and Leg Wounds
Although diabetic leg ulcers and peripheral vascular disease wounds are different, they may share some of the same causes and risk factors. According to Science Direct’s study, “It is reported that diabetes is associated with a two to four-fold increase in the incidence of peripheral arterial disease (PAD) compared to non-diabetic subjects.”
Diabetes and PAD go hand-in-hand because the lining in your blood vessels becomes less flexible allowing plaque to build up even easier. When blood isn’t able to move freely, blockages tend to occur. Not only does diabetes irritate and inflame the lining of your blood vessels, but it can also compromise your ability to fight infections which could cause open wounds to not heal properly.
Lastly, high blood pressure, increased cholesterol levels, family history of vascular disease, and diabetes (especially type 2) are all linked as causal factors for peripheral vascular disease wounds. That said, if you’re at an increased risk, you should be monitoring any slow-healing wounds or diabetic leg ulcers so you can notify your doctor.
How Are Slow-Healing Sores Diagnosed?
Peripheral vascular disease wounds are often diagnosed when they have progressed significantly. By the time most people go to the doctor, the wound has become infected and there is visible discomfort. However, that doesn’t have to be you. If you notice signs or symptoms of peripheral artery disease, are at an increased risk, or have a slow-healing sore that won’t heal, you can get help before it gets worse. Yan Katsnelson, M.D., says that treating the underlying condition of PAD will help the open wound on your leg close up on its own and heal properly.
Diagnosis starts by determining the underlying condition of your slow-healing wound such as diabetes, PAD, or both. Then, your doctor may prescribe you to visit a vascular specialist like those at USA Vascular Centers, to undergo an ankle-brachial index (ABI) or angiogram. These tests can help determine how severe your PAD is, so your physician can suggest the right treatment decision for you.
Risk of Amputation Due to Peripheral Vascular Disease
Amputation due to peripheral vascular disease is something most people would rather not talk about. However, it’s an incredibly important issue that needs to be addressed if you’re at an increased risk for developing PAD. Although amputation due to peripheral vascular disease sounds like a rare complication, it is unfortunately quite common. Out of all the people who have lost a limb, 54% was caused by vascular conditions like PAD as well as diabetes.
Amputation due to peripheral vascular disease may become necessary if the severity of your PAD has caused a complete blockage for a critical amount of time. Gangrene, tissue death, sets in when poor circulation caused by PAD has progressed. Once this happens, it becomes extremely difficult for physicians to save the limb.
Thankfully, PAD is extremely treatable if diagnosed early. That’s why at USA Vascular Centers, we aim to raise PAD awareness and inform at-risk individuals so they can get diagnosed and treated as early as possible. Amputation due to peripheral vascular disease is avoidable as long as you use the correct precautions. Noticing slow or non-healing wounds on your legs, ankles, or feet, is a proactive way to prevent amputation, as well as heart attacks and strokes.
Treatment for Peripheral Vascular Disease Wounds
If you’ve been living with painful symptoms or peripheral vascular disease wounds on your legs, it’s time to find a treatment center you can trust. Living with limited mobility and leg wounds that do not heal is not your only option. If you’re worried about undergoing surgery to treat your PAD, that’s not a problem either.
At USA Vascular Centers, we offer non-surgical, office-based treatments that take less than two hours from start to finish. Our vascular specialists utilize interventional techniques like live x-ray guidance to treat peripheral artery disease before it worsens.
Dr. Yan Katsnelson is a philanthropist, business owner, and highly skilled cardiac surgeon. He is the Founder and CEO of USA Vascular Centers, which is part of USA Clinics Group, the parent company of USA Fibroid Centers, USA Vein Clinics, and USA Oncology Centers with more than 90 facilities nationwide. Dr. Yan has established himself as a strong advocate for accessibility and affordability of the most advanced medical care close to home, and his mission is to create a positive experience for each patient with compassionate, personalized, and expert care.