Peripheral Arterial Disease (PAD) and Wound Care

One in every eight Americans older than 60 years of age have PAD. In all, PAD affects as many as 12 million people in the United States. Slightly more men than women have the disease. Due to the prevalence of PAD, September was named Peripheral Arterial Disease Awareness Month by the US Senate in 2007.

Peripheral arterial disease (PAD) is a condition that develops when the arteries that supply blood to the arms or legs become completely or partially blocked as a result of atherosclerosis.

There are many possible side effects of atherosclerosis including angina and heart attacks if the coronary arteries are involved; strokes and transient ischemic attacks if the carotid and vertebral arteries are involved; and claudication, non-healing leg ulcers and critical limb ischemia if the lower extremity arteries are involved.

Common risk factors include high cholesterol, smoking, high blood pressure, diabetes, atherosclerosis and age. Smokers are four times at greater risk, African Americans are three times as likely to have PAD, and one in every three people over the age of 50 with diabetes is likely to have the disease.

PAD is diagnosed by healthcare professionals who review medical history and tobacco use, and perform 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.

For patients with chronic wounds and their healthcare providers, PAD poses particular problems. Chronic toe and foot sores are common in people with PAD, as are cramping, numbness, weakness or heaviness in the leg muscles. However, many patients with PAD do not experience symptoms. That’s why the DeKalb Regional Wound Care Clinic performs tests for PAD, treats chronic wounds which may have underlying conditions of PAD and counsels patients on how to manage PAD.

The DeKalb Regional Wound Care Clinic recommends 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, contact the DeKalb Regional Wound Care Clinic at 590 Medical Center Drive, Fort Payne, AL or 256-997-2526.