Peripheral Arterial Disease (PAD) and Wound Care

By Todd Quincy

One in every 20 Americans older than 50 years of age have Peripheral arterial disease (PAD), a condition that develops when the arteries that supply blood to the internal organs, arms and legs become completely or partially blocked as a result of atherosclerosis (hardening and narrowing of the arteries).

According to Ji Woo Lee, MD, formerly with the TriHealth Advanced Wound Healing Centers, common risk factors for developing PAD include high cholesterol, smoking, high blood pressure, diabetes, atherosclerosis and age. Slightly more men than women develop the disease.

PAD poses particular problems for patients with chronic wounds.  Chronic toe and foot sores are common in people with PAD, as are cramping, numbness, weakness or heaviness in the leg muscles. Many patients with PAD do not experience symptoms. That’s why the providers at the TriHealth Advanced Wound Healing Centers perform tests for PAD, treat chronic wounds which may have underlying conditions of PAD and counsel patients on how to manage PAD.

Healthcare professionals use many avenues for diagnosing PAD such as medical history, tobacco use, physical exams and diagnostic tests. An ankle-brachial index (ABI) test may be performed, as well. An ABI test is painless and easy, and involves a comparison between a blood pressure reading in the ankles and a blood pressure reading in the arms. An ABI can help diagnose PAD, but it cannot identify which arteries are narrowed or blocked. A doppler ultrasound test may be done to see which artery or arteries are blocked.

The TriHealth Advanced Wound Healing Centers recommend the following action steps to help manage PAD:

• Lifestyle changes such as quitting smoking, correcting blood pressure and cholesterol numbers
  • Smoking, high blood pressure and high cholesterol are major risk factors for the development of PAD. Managing these conditions can help improve blood circulation.
• Develop healthy eating habits and an exercise plan
  • Exercising can help increase the circulation and reduce pain in the lower extremities. Walking, hiking and bike riding are good exercise options. A personal trainer can help tailor a custom workout plan that best fits a person’s needs.
• Medications
  • Always consult with a physician about which medications may help PAD and if they are needed.
• Special procedures and surgeries
  • In some severe cases of PAD, surgery may be needed to open arteries that have narrowed. Consult with a physician to see if surgery is a necessary treatment.

For more information about PAD and treating chronic wounds, contact TriHealth Advanced Wound Healing Centers at Bethesda North Hospital at 513 865 5050 or at Good Samaritan Hospital at 513 862 5050.