What are Treatment Options for Peripheral Arterial Disease (PAD)?

What are Treatment Options for Peripheral Arterial Disease (PAD)?

Arteries are a part of a circulatory system. They are the vessels which supply oxygenated blood to your body. Proper functioning of arteries is necessary as oxygenated blood is the driving force behind the function of every single cell in your body. If arteries fail to supply blood properly, cyanosis and eventually cell death ensue.

Peripheral arterial disease (PAD)

is a disorder of peripheral arties. In this disease, plaques are formed in blood vessels, leading to a narrow lumen. Narrow blood vessels don’t supply blood as efficiently. This creates many issues.
Symptoms of peripheral arterial disease (PAD) include claudication (leg pain while walking), numbness or weakness of the limbs, cold hand and feet, sores on peripheral areas that won’t heal, cyanosis of leg and feet, hair loss over involved area, slow growth of toenails, no pulse or weak pulse in peripheral areas, shiny skin over involved area, and erectile dysfunction or impotence in men.
It is important to get the disease treated with an appearance of the first sign that is usually claudication. There are various preventive measures and treatment options that can be adopted to get rid of this condition. Let’s discuss a few. Prevention Is Better Than Cure
Preventing this disease is the best option. Prevention involves eliminating risk factors and taking good care. Following are a few preventive measures.

* Quit smoking.
* Control your blood sugar levels if you have diabetes.
* Make sure that your cholesterol levels are normal.
* Lose excess weight.
* Control your blood pressure.
* Adopt exercise.
* Eat healthy. Decrease fat intake and add fresh fruits and vegetables.

Medical Treatment Options
Medical treatment involves the use of drugs. Medical treatment is usually the first choice when the disease is in initial stages. It is also adopted with other treatment options. Following are a few drugs which are generally used.

* Cholesterol-lowering drugs like statins.
* Blood pressure controlling drugs like a diuretic, calcium channel blockers, and ACE inhibitors etc.
* Medications to control blood sugar levels.
* Drugs that prevent blood clots in blood vessels like clopidogrel.
* Drugs that increase blood flow towards limb like cilostazol and pentoxifylline.

Interventional Treatments
These treatment options are newer. They are minimally invasive procedures that provide good relief. A balloon is passed into the affected blood vessel with the help of imaging modalities. Balloons can be used to dilate blocked artery.
A stent is another option. Stents are passed into blocked blood vessels and hence not only blockage is treated but they are saved from being collapsed as well.

Surgical Treatments
These are fully invasive procedures which are adopted in cases where treatment with other options is not possible. It mostly occurs in severe occlusion of a blood vessel and when symptoms start appearing even at rest.
Bypass surgery is the most popular technique. In this technique, a graft from some other artery is taken and the blocked region is bypassed by performing a surgery. Taking preventive measures is necessary after the procedure to avoid recurrences.

Muzammal Habib, MD

Vascular Medicine and vein specialist

Dr. Habib has been practicing vein care and vascular More about this author »

Author

Muzammal Habib, MD

Vascular Medicine and vein specialist

  (855) – 798 – 3467
  www.bostonveincare.org 

  Contact / Book An Appointment 

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Muzzamal Habib, MD

VeinTV.com serves to educate patients suffering from vein, wound, vascular and cardiology problems. All our authors are recognized leaders in their fields.

General Advice For Wound Patients

General Advice For Wound Patients

A wound is a discontinuity on the surface of the skin. While most wounds are caused by some kind of trauma, others can occur due to possible chronic underlying conditions. Examples of such wounds are diabetic wounds and venous wounds etc. Chronic and untreated conditions can cause these wounds; therefore, treating them is difficult without controlling the etiological factors and taking special care.
Wounds are a commonly experienced, painful, and debilitating condition. Untreated wounds can increase in size and can even require amputation. This is why such wounds should be taken seriously and proper treatment should be undertaken before potential complications.
There are special care instructions that should be followed when treating wounds. The following are the important steps.

Keep Your Follow Up Visits
Getting your wound examined on time may not be sufficient. Depending on the severity of the wound, it may be important to make weekly visits to your doctor. It will ensure the best care and the fastest healing. Random visits or no visits at all can be harmful. They not only prolong the healing time but can also lead to complications.

Wound Cleaning
This is a very important step because it ensures that your wound is sterile and does not become infected. Also, foreign bodies in your wound can interfere with the healing process. This is why proper cleaning is mandatory.
The wound is normally cleaned with normal saline. However, you can ask your wound specialist doctor if you can use shower, bath, use soap or not.

Changing Wound Dressing
The frequency of changing wound dressing is also decided by your wound specialist doctor. Your doctor also chooses the appropriate dressing for the wound based on the presence of drainage or not.
Usually, the aim is to keep the wound moisturized. However, this moisture should not be excessive because it may damage the surrounding skin. Dry wounds delay healing, so maintaining a proper level of moisture is important.

Controlling Edema
Edema leads to delay in wound healing because it causes accumulation of fluid in the tissue. There are various steps and instructions that should be followed in order to control edema.

* Avoid prolonged standing in one place because it leads to dependent edema
* Elevate legs when sitting and take them above the level of heart when in bed.
* Use knee-high gradient compression stockings with 20-30 mmHg pressure or compression wraps. They should be used only during the day and removed at night.
* Use Una boot with zinc from toe to knee.
* You can also use compression pumps. Use them 90 minutes twice per day, or 60 minutes three times a day.

Following are a few other care instructions

* Increase protein intake and eat a balanced diet to encourage wound healing. Dietary deficiency of zinc and vitamin C etc. can delay wound healing.
* Apply moisturizing lotion to the skin surrounding the wound.
* Exercise and increase your physical activity as recommended by your doctor or cardiologist.
* Lose excess pounds because being overweight can lead to edema.
* Stop smoking. It causes various health issues.
* Take a multivitamin daily to make sure you are fulfilling requirements of your body.

Muzammal Habib, MD

Vascular Medicine and vein specialist

Dr. Habib has been practicing vein care and vascular More about this author »

Author

Muzammal Habib, MD

Vascular Medicine and vein specialist

  (855) – 798 – 3467
  www.bostonveincare.org 

  Contact / Book An Appointment 

More about this author »

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Muzzamal Habib, MD

VeinTV.com serves to educate patients suffering from vein, wound, vascular and cardiology problems. All our authors are recognized leaders in their fields.

How To Best Treat Venous Wounds?

How To Best Treat Venous Wounds?

There are different types of wounds. Wound classification is based on various factors like underlying disease, injurious agent, and morphology of wound etc (the use of etc in a blog designed for patients is slightly confusing because the reader won’t know what are other options after “etc.”). Venous wounds are a type of wound. They are caused by dysfunction of the venous system and they mostly occur on legs, especially near feet.
Venous wounds or ulcers are usually shallow. The most common cause behind these wounds is incompetency of valves of the venous system of leg or legs. This incompetency causes pooling of the blood in the legs. Other causes include deep venous thrombosis (DVT), obesity, smoking, lack of physical activity, and performing activities that require standing for long periods of time etc. Chronic pooling eventually leads to the formation of venous wounds or ulcers.
When the blood pools into veins in the legs, it starts leaking out in surrounding tissues. This damages the tissues and as veins are usually superficial, wound or ulcer formation occurs.
These wounds are most commonly noticed on the sides of the legs on the lower area, above the ankle, and below the calves. These wounds or ulcers are known for their slow healing and they can come back quickly if the underlying issue is not treated. This is why treating the underlying cause is necessary along with taking care of the wound.
The following are a few treatment options for venous wounds. Compression Therapy
Compression therapy is a standard care option and has been proven to be beneficial for venous wounds. It involves the application of pressure on the legs, which promotes the return of blood to the heart. It decreases edema, makes venous reflux minimum, fastens wound healing, and manages pain.
There are different ways to give compression therapy. These include elastic compression, inelastic compression, and intermittent pneumatic compression. Intermittent pneumatic compression therapy involves a pump which has the function to deliver air to an inflatable and deflatable cuff that covers the extremities. This intermittent air delivery compresses the leg.

Leg Elevation
As blood pooling in the venous system of the legs is the major cause of these wounds, leg elevation is a technique which provides relief. It can be used in combination with compression therapy, or alone as a standard treatment option.
This technique involves raising the legs above heart level. It promotes blood flow toward the heart and subsequently relieves pooling. It is usually recommended for thirty minutes, three to four times a day, for visible results.

Dressing Of The Wound
While dressing has a major role in treating other wounds, it has not been proven to be any better than available treatment options for venous ulcers. However, it can be opted as per the preferences of the patient and the requirement of the wound. (this last sentence is probably not necessary)
There are various different dressings available that include compression bandages, hydrogel, foams, hydrocolloids, pastes, and non-adherent dressing etc.

Drug Treatments
There are various drugs that can help with the treatment of venous wounds. These drugs include aspirin, pentoxifylline, iloprost, antibiotics, and zinc therapy. These drugs have the different mechanism of actions.
A newer option is hyperbaric oxygen therapy. In this procedure, high-pressure oxygen is applied to wound. It has anti-bacterial and anti-inflammatory effects. However, this therapy is more beneficial for other kinds of wounds.

Surgical Treatment Options
The available surgical treatment options focus on treating the underlying cause and closure of the wound. These options include surgical debridement of the wound and skin grafting. Surgical debridement is of various types and it makes sure that wound is clean and free of any debris. Skin grafting closes the wound.
Other surgical treatments involve treating the insufficient valves using different techniques that eventually lead to wound healing.

Vacuum-Assisted Closure
Vacuum-assisted closure is a newer technique. It involves the closure of the wound mechanically by applying negative pressure topically using a vacuum device. This technique reduces the wound size and volume to a significant extent.

Muzammal Habib, MD

Vascular Medicine and vein specialist

Dr. Habib has been practicing vein care and vascular More about this author »

Author

Muzammal Habib, MD

Vascular Medicine and vein specialist

  (855) – 798 – 3467
  www.bostonveincare.org 

  Contact / Book An Appointment 

More about this author »

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A service provided by bestveinclinics.com

Muzzamal Habib, MD

VeinTV.com serves to educate patients suffering from vein, wound, vascular and cardiology problems. All our authors are recognized leaders in their fields.

What Are the Potential Complications of Untreated Varicose Veins?

What Are the Potential Complications of Untreated Varicose Veins?

The varicose vein is a disease of the venous system of one or both of the legs. This disease is characterized by the presence of dilated and enlarged veins that are visible on the skin surface. These veins look blue or purple because they contain deoxygenated blood.
There are various causes of varicose veins such as aging, pregnancy, deep venous thrombosis (DVT), and obesity. These factors may cause varicose veins by either making the valves incompetent or by increasing the blood pressure in the venous system of the legs. Both these mechanisms promote backflow of blood toward superficial veins that lead to varicose veins.
Varicose veins are not generally a life-threatening disease if it is mild and not long-standing. However, proper treatment should always be undertaken to avoid any potential complications like deep venous thrombosis (DVT) which can be deadly. The following is a list of potential complications of untreated varicose veins.

Bleeding
As varicose veins are superficial, dilated, and prominent, they are very prone to damage and can start bleeding due to minor trauma. This bleeding is usually copious in amount and does not stop easily. Direct pressure should be applied along with raising the involved leg in order to stop the bleeding.

Deep Venous Thrombosis (DVT)
Varicose veins cause stasis of blood in the legs due to incompetent valves and faulty blood flow. This stagnant blood in the leg can start developing clots and the condition known as deep venous thrombosis (DVT). These clots can worsen the condition and compromise blood supply of the involved area, leading to severe pain. If these clots dislodge, they can move to the lung and cause a life-threatening condition known as pulmonary embolism.
If you are suffering from varicose veins and suddenly develop severe pain in the leg or chest, contact your doctor immediately.

Superficial Thrombophlebitis
Thrombophlebitis is actually a manifestation of blood clots in the superficial veins. When blood clots form in the superficial veins, or in this case in varicose veins, they can cause pain, swelling, and redness. These symptoms indicate inflammation of venous walls and can be treated by using non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen etc.

Ulcers Due to Varicose Veins
Ulcers can form on the legs due to long-standing varicose veins. As these ulcers are a result of venous disease, they are known as venous ulcers. Due to increased blood pressure in the affected leg, the fluid from the blood moves out of the veins and starts collecting below the skin. This causes thickening and swelling of the skin that ultimately leads to ulcer formation. These ulcers most commonly form around the ankle.

Lipodermatosclerosis
This is another complication of long-standing varicose veins. It is actually the inflammation of the fat under the skin surface due to the disease. Long-standing inflammation can cause scarring in the fat and on the skin. This leads to hardening of skin (sclerosis), swelling, redness, and increased pigmentation. Lipodermatosclerosis usually involves the calf area of the involved leg.

Eczema Due to Varicose Veins
Long-standing and untreated varicose veins can also lead to skin eczema. Eczema is characterized by dry and scaly skin over the area suffering from varicose veins. Blister formation can also occur. This condition is typically chronic but it does not pose any serious health hazards.
It is always advised to have your varicose veins treated in a timely manner. Although they do not typically cause any life-threatening problems, it is always beneficial to have a physician ensure they do not need treatment to help avoid potential complications of this disease.

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Muzammal Habib, MD

Vascular Medicine and vein specialist

Dr. Habib has been practicing vein care and vascular More about this author »

Author

Muzammal Habib, MD

Vascular Medicine and vein specialist

  (855) – 798 – 3467
  www.bostonveincare.org 

  Contact / Book An Appointment 

More about this author »

FIND A DOCTOR!



A service provided by bestveinclinics.com

Muzzamal Habib, MD

VeinTV.com serves to educate patients suffering from vein, wound, vascular and cardiology problems. All our authors are recognized leaders in their fields.

How Can Patients help Diabetic Wounds to Heal?

How Can Patients help Diabetic Wounds to Heal?

Diabetes is a disease which affects many organs and causes several complications. Diabetic wounds are one of the complications of poorly controlled diabetes that are bothersome and can lead to dangerous consequences. Diabetes is characterized by raised blood glucose levels. Once you are diagnosed with diabetes, it is important to maintain your blood glucose levels within normal ranges. There are various treatment options for diabetes and your doctor chooses the one which is the best for you as per your condition. You need lifestyle modifications, drugs, and sometimes insulin.
Patients face complications, such as diabetic wounds, when they do not maintain blood sugar levels within normal limits due to non-compliance to drugs and doctor recommendations.
Lifestyle modifications for diabetes also involve proper foot care. If you fail to take care of your feet as directed by the doctor, there is a higher risk of developing diabetic wounds. The following are options to promote healing of such wounds.

Adopt A Care Routine
If you are a diabetic person who is at risk of developing diabetic wounds or if you already have a diabetic wound, you need to follow a foot care routine to make sure that your wound does not expand and new wounds do not develop. The following are steps that should be included in your daily foot care:

  • Examine your foot daily. Diabetes decreases the sensitivity of your feet due to nerve damage. It leads to an inability to localize a damaging stimulus and hence wounds go unnoticed.
  • Inspect your wound daily to see any signs of infection or spreading.
  • Wash your feet carefully with warm water and make sure you dry them completely, especially between toes. After that, apply some moisturizer as cracks on the skin can turn into new wounds.
  • Choose your footwear wisely. You need comfortable shoes that do not cause pain. Wearing narrow or pointed shoes can delay the healing of wounds and can lead to new diabetic wounds as well.
  • Clip your toenails carefully. Improper clipping is an important source of wounds that can grow bigger. You may need to ask for help from an expert.
  • Control Your Blood Sugar Levels

As uncontrolled diabetes is the cause of wound development, proper healing requires controlling blood sugar levels within normal ranges for diabetic patients. For this reason, you need to be compliant with your medications. You should also make necessary lifestyle changes, like diet modifications and adoption of a walking routine, etc.

Take Care Of The Wounds Without Delay
Every little wound should be managed and monitored. As soon as you develop a wound, immediately tend to it because diabetic people are at higher risk of developing the infection. The wound healing is also delayed with diabetes. Therefore, never ignore even a minor cut, as it can turn into a big issue if left untreated.

Clean The Wound
Clean your wound with clear water and do not apply hydrogen peroxide, iodine, soap, or any similar agents as they can irritate your wound. Apply your antibiotic ointment suggested by the doctor and cover the wound with a sterile bandage. Change your bandage regularly. Keep the surrounding skin clean. You can wash it with soap carefully. (didn’t you just say not to use soap? I’d make it more clear when you are permitted to use soap)

Don’t Put Pressure On Wound
Diabetic people often develop wounds on the sole of their foot. This is why there is a need to avoid pressure as it delays healing. Make sure that you avoid putting pressure on your sole or at any other spot where the wound is.

When To Consult Your Doctor
Home care of the wound is necessary for proper wound healing. However, if you realize that your wound is not healing or it is expanding, contact your doctor. Never take a risk as these minor wounds can lead to amputations if not treated in a timely manner. It is also necessary to get your wound inspected from time to time by the doctor.

Muzammal Habib, MD

Vascular Medicine and vein specialist

Dr. Habib has been practicing vein care and vascular More about this author »

Author

Muzammal Habib, MD

Vascular Medicine and vein specialist

  (855) – 798 – 3467
  www.bostonveincare.org 

  Contact / Book An Appointment 

More about this author »

FIND A DOCTOR!



A service provided by bestveinclinics.com

Muzzamal Habib, MD

VeinTV.com serves to educate patients suffering from vein, wound, vascular and cardiology problems. All our authors are recognized leaders in their fields.

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