This article was published in Today’s Wound Clinic, Volume 7, Issue 5 (June/July) 2013 and is available on-line.
It was authored by myself and Michael Cioroiu MD, FACS, CWS, who is co-director of the Center for Advanced Wound Care at Beth Israel Medical Center.
Peripheral arterial disease (PAD) of the lower limbs is often neglected when evaluating reasons for poor wound healing, particularly in elderly patients. Affecting roughly 12-14% of the general US population, PAD increases with age and affects up to 20% of patients who are older than 75.1 Risk factors include diabetes mellitus, hypertension, smoking, and hyperlipidemia. PAD can also critically hamper one’s wound healing as well as prevent optimum delivery of systemic antibiotics, which can result in polymicrobial infections and advancement to osteomyelitis. The healing of any wound of the lower extremity, including those from trauma, pressure, or venous stasis, can be adversely affected by poor perfusion associated with atherosclerotic disease.