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ARTERIAL AND VENOUS WOUNDS
View a video about Peripheral Vascular Disease
A basic component to healing an arterial/venous wound is making sure
there is good blood flow to the area. Dysfunction of lower extremity
arteries or veins may lead to the development of chronic, nonhealing
wounds. Treatment of these wounds may be relatively simple or quite complex,
depending on the underlying cause of the wound requiring a coordinated
approach. After initial assessment of the leg veins and arteries (usually
with ultrasound), appropriate individualized treatment plans can be made.
Eventual treatment may include further diagnostic testing.
VENOUS
The veins of the leg may be divided into deep and superficial systems,
both of which serve to channel blood out of the lower extremity and toward
the heart. This flow is assisted by the calf muscle pump, which squeezes
blood in the deep calf veins out of the leg whenever the calf muscles
contract. Reverse flow of venous blood to the foot is prevented by numerous
venous valves, which close to counter the effect of gravity. Progressive
damage to this system through advancing age, trauma, or persistently
high venous pressures causes valve failure and blood pooling in the leg
veins. Without intervention, this situation leads to feelings of heaviness
and fatigue, and in more severe cases can result in severe leg edema
and leg ulceration. Patients often relate a history of leg swelling which
improves when the leg is elevated. Venous leg ulceration is a complex,
multidisciplinary problem, but proper treatment can yield excellent results.
For venous wounds, compression therapy is often prescribed.
ARTERIAL
Some wounds will not heal because there is decreased arterial blood
flow to the area. A common contributor to this condition is atherosclerosis,
a gradual clogging of the arteries, over many years, by fatty materials
and other substances in the blood stream. For wounds that have arterial
involvement, evaluation by a vascular surgeon, interventional or surgical
procedures (angioplasty, stenting, or bypass surgery) may be needed.
Sometimes wounds
have both arterial and venous components. Our center’s
physicians will determine what combination of treatments is most appropriate
for your particular situation.
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