Wound Management in the Presence of Peripheral Arterial Disease

Abstract

The prevalence of peripheral arterial disease increases with age. The elevated risk of ulcerations leading to amputation among the elderly refl ects not only increased rates of peripheral arterial disease and diabetic pathologies but also age-related changes of the integument. Limb salvage is most successful when clinical and educational interventions are utilized that address the etiology of peripheral arterial disease and the physiologic requirements needed to support the integument. Complete and accurate assessment is essential to guide health care providers in formulating effi cacious plans of care. Selected interventions may include any combination of pharmaceutical, technological, surgical, and educational approaches. This article reviews the pathology of arterial ulcerations and provides best practice standards for examination and intervention of integumentary disruption as related to arterial pathology.

Assessing chronic wound perfusion in the lower extremity: current and emerging approaches

“…PAD is one of the leading conditions that can alter perfusion and thereby increase susceptibility to localized tissue ischemia, contributing to delayed healing of lower extremity ulcers. 16 PAD is primarily caused by progressive atherosclerotic changes in the arteries reducing normal blood flow to the lower extremities. It is thought to affect approximately 4% of the population over the age of 40 years and 20% over 75 years or an estimated 25 million individuals in North America and Europe.…”