Vascular Wound Care Specialist in Los Angeles

Skin ulceration can occur when either veins, arteries, or both malfunction. Many are surprised to learn that venous insufficiency contributes to approximately 70% of vascular wounds, while arterial disease accounts for 5 to 10%. At the same time, as many as 26% of leg ulcers have both venous and arterial causes [3,4].

Causes of Arterial Wounds

Causes of Venous Wounds

Ultimately, CVI results in limited blood flow toward the heart. Without the ability to return blood back to the body’s main circulatory pump, blood pools in the extremities and backs up in the veins. The increased blood volume surpasses the veins’ natural reservoir capacity and exerts increased pressure on the vessels, causing undue stress and eventual failure. As more of the venous system is affected and blood flow is further compromised, skin color changes in the lower leg and wounds form as tissue breaks down. Risk factors for venous wound formation include: older age, sedentary lifestyle, high body mass index, arterial hypertension, deep vein thrombosis, deep vein reflux, and a family history of venous leg wounds [6].

Arterial Wounds

Arterial wounds typically develop over bony parts of the foot as well as the heels and toes, past the point of vessel occlusion. These can be shallow or deep skin wounds with or without gangrene. Arterial wounds have well-defined edges and appear to be “punched out.” The center of the wound, the wound base, is pale in color (grey or yellow). Skin surrounding the arterial wound may be red, cold to the touch, shiny, and hairless [7].

Venous Wounds

As vein disease increases in severity, constant swelling, fat destruction (lipodermatosclerosis), and skin discoloration and deterioration occur anywhere between the knee and ankle [4, 7-9]. Appearance-wise, the skin surrounding the wound looks shiny, thin, hairless, and hyperpigmented with a brown color. The wound itself has sloping edges, and exudate fluid may ooze from the wound. Venous wounds are shallow and irregularly shaped. Pain is usually less severe compared to arterial wounds unless there is an active infection or excessive swelling.

Treating vascular wounds isn’t just about addressing the visible leg ulcer, but also the underlying disease process that created them in the first place. The root cause of arterial and venous wound formation is vascular disease such as advanced peripheral artery disease and chronic venous insufficiency. However, many lower extremity wounds have a multifactorial set of causes (in addition to vascular disease), and therefore require multiple, simultaneous treatment approaches.

A multidisciplinary team consisting of wound care specialists, podiatrists, physical therapists, primary care physicians, and vascular interventionalists will provide the best care for a patient suffering from venous or arterial leg ulcerations attributable to vessel disease [2-3,10]. Vascular interventionalists include general and vascular surgeons, who are best-suited to treat advanced vessel disease through invasive surgeries. They also include interventional radiologists, who specialize in minimally invasive approaches to improve blood flow.

Arterial Wound Care & Treatments

Lifestyle Changes and Medicine

Arterial Wound Care

Patients who present with open, non healing arterial wounds are typically referred to a wound doctor who will clean the wound routinely and dress it with bandages to prevent infection and promote healing of the skin. Arterial wound dressing changes do not target the underlying arterial disease that causes the wounds, however, arterial wound care is still an essential part of healing and complements other treatments.

Minimally Invasive Revascularization

Your Partner in Vascular Care

Venous Wound Care & Treatments

Compression Stockings

Venous Wound Care

Patients who present with open, non healing venous wounds are typically referred to a wound care specialist who will clean the wound routinely and dress it with bandages to prevent infection and promote healing of the skin. Changes to the wound dressing for venous leg ulcers do not target the underlying vein disease that causes venous ulceration, however, venous wound care is still an essential part of healing and complements other treatments.

Superficial Vein Closure

Deep Vein Revascularization

At ProVascularMD, we provide minimally invasive wound care, both arterial wound treatment and venous wound treatment. Our vascular and interventional radiologists specialize in revascularization techniques to treat peripheral artery disease, and vein closure treatment for venous insufficiency. Give us a call today to schedule your visit with a vascular wound care specialist in Los Angeles!