THE VITAL ROLE OF VASCULAR HEALTH IN CHRONIC WOUND HEALING

Every September, the United States recognizes National Vascular Disease Awareness Month. This is a crucial time to highlight the often-neglected health of our blood vessels. While people often discuss heart health in relation to circulation, vascular health is equally important. This is especially true concerning one of the most ongoing medical issues: chronic wounds.

Chronic wounds, like diabetic foot ulcers, venous leg ulcers, and pressure injuries, impact millions of Americans every year. These wounds are not only slow to heal, but they often fail to heal at all without targeted intervention. And one of the most significant, yet underappreciated, contributors to their persistence is poor vascular health.

Understanding Vascular Health

Your vascular system, also known as the circulatory system, consists of arteries, veins, and capillaries. It transports oxygen, nutrients, hormones, and immune cells throughout the body. Arteries carry oxygen-rich blood from the heart to the tissues. Veins bring back oxygen-depleted blood to the heart. Capillaries connect the two, allowing nutrient exchange at the cellular level.

When this complex system is compromised by plaque buildup, blood clots, vein problems, or inflammation, tissues get less oxygen and fewer nutrients. This makes it harder for the body to heal, especially in areas like the lower legs, where blood flow is already more challenging due to gravity.

Why Chronic Wounds Need Healthy Vessels

Wound healing is a complex biological process that takes place in several stages: hemostasis (blood clotting), inflammation, proliferation (tissue growth), and remodeling. Each stage is highly dependent on a good blood supply:

• Oxygen delivery is essential for creating collagen and new tissue.
• Transport of immune cells is necessary to fight infection and clear debris.
• Nutrient exchange fuels the regeneration process.

Without proper vascular function, wounds can get stuck in the inflammatory phase or may not progress through the stages at all. This leads to chronic, non-healing wounds that can last for months or even years. In severe cases, this can lead to infections, amputations, or systemic illness.

Warning Signs: When Vascular Issues May Be Affecting Wound Healing

Patients and caregivers should be alert to signs that may indicate poor circulation or vascular disease, delaying wound healing. On their own, these symptoms might seem minor, but if several are present together, they may point to a more serious vascular issue requiring medical attention and evaluation:

• Wounds that don’t heal within 30 days
• Pain in the legs, especially when walking or at night (claudication or rest pain)
• Skin discoloration (bluish, reddish, or pale tone around the wound or toes)
• Coldness or numbness in the feet or toes
• Thickened, brittle toenails or slow nail growth
• Hair loss on legs or feet
• Shiny, thin, or tight-looking skin
• Swelling in the legs, ankles, or feet
• Visible varicose veins or spider veins
• Ulcers that appear over bony areas (like ankles) or in places prone to pressure

If a patient notices several signs, especially along with a non-healing wound, they should seek medical attention immediately. Early treatment can dramatically improve outcomes and even prevent complications like infection or amputation.

Key Vascular Conditions That Affect Wound Healing

1. Peripheral Artery Disease (PAD)
   PAD is a common circulatory problem where narrowed arteries reduce blood flow to the limbs. It affects more than 8.5 million people in the U.S., particularly those over 60. PAD significantly increases the risk of chronic wounds and amputations.
2. Chronic Venous Insufficiency (CVI)
   When the valves in the leg veins stop working, blood pools in the lower limbs instead of going back to the heart. This can create pressure in the veins, damaging skin tissue and leading to venous leg ulcers.
3. Diabetes-Related Vascular Damage
   High blood sugar levels harm blood vessels over time, especially the small capillaries. Diabetic patients often develop neuropathy and poor circulation. This dangerous combination can lead to foot ulcers and poor wound healing.

Improving Vascular Health for Better Healing

The good news is that improving vascular health can directly support wound healing and prevent chronic wounds from forming. Here's how patients and healthcare providers can work together:

• Early Screening and Diagnosis
  Identifying vascular disease early through ankle-brachial index (ABI) tests, Doppler ultrasounds, and clinical evaluation can help address circulation issues before wounds develop.
• Lifestyle Modifications
  Quitting smoking, exercising regularly, managing diabetes and hypertension, and eating a heart-healthy diet are all important strategies for improving vascular health.
• Compression Therapy and Elevation
  For venous insufficiency, wearing compression stockings consistently and elevating the legs help improve venous return and reduce pressure in the lower limbs.
• Revascularization Procedures
  In cases of severe arterial blockages, procedures like angioplasty or bypass surgery can restore blood flow to affected areas, giving chronic wounds a better chance to heal.
• Multidisciplinary Wound Care
  Vascular surgeons, podiatrists, wound care specialists, and primary care providers need to collaborate to develop individualized care plans. Optimal wound healing relies on a team approach.

Spreading Awareness This September

During National Vascular Disease Awareness Month, we are reminded that healthy blood flow is crucial for the body. Chronic wounds might seem like just a surface issue, but they often signal deeper problems in the vascular system. By focusing on vascular health, we can prevent wounds, speed up healing, and lessen the impact of this chronic condition on individuals and the healthcare system.

Whether you are a patient, caregiver, or healthcare professional, now is the time to take vascular health seriously. Talk to your doctor about your risk factors, get screened, and learn more about how circulation affects your overall health.

Healthy blood vessels lead to healthier lives, and healing starts from within.

Author

Jenna Wishnew Dr. Jenna Wishnew is a board-certified general surgeon with over a decade of experience serving the North Dallas community. Known for her compassionate, patient-centered care, she specializes in wound care and hyperbaric oxygen therapy (HBOT), currently serving as Medical Director at the Wound Care and Hyperbaric Center at Methodist Richardson Medical Center. Dr. Wishnew is a recognized leader in her field, earning two international awards for excellence in wound care. She also has extensive experience managing gastroparesis and Enterra Gastric Stimulators.