may notice hair loss from the knee down. More developed signs include trouble walking short distances and pain in the legs caused by restricted blood flow. Insulin resistance, tobacco use, lack of exercise, high stress and diabetes are risk factors for peripheral artery disease and even coronary artery disease. Diabetes might exacerbate wound development because it can attack nerves, which could lead to neuropathy – when the nerves in the feet no longer are responsive. “The loss of sensation puts their skin at risk,” said Dr. Arthurs. The patient might not even notice the wound right away. Combined with restricted blood flow, the sensation in the bones that directs growth and maintains health is reduced, and it’s possible that the person will place weight inappropriately across the foot, causing eroding or pushing bone to wear on the skin. When a patient with PAD is wounded, blockage in the arteries prevents the wound from receiving blood supply due to imbalanced inflammation in the body and resulting plaque buildup in the arteries. Additionally, diabetes diminishes a healthy immune system, confusing the signals that tell the body to direct repairing cells to the site of the wound. When people with PAD or diabetes notice a wound, they should go immediately to a wound care center or vascular specialist. “It’s critical to get in immediately, to get that local wound care,” said Dr. Arthurs, adding that people with healthy immune systems should seek medical care if a would does not heal within three to five days. To treat a wound, Dr. Arthurs works to bring blood flow to the site to stimulate new growth and heal the skin. After initial treatment, the wound is constantly re-evaluated. Patients may need to see a physician weekly for an examination and debridement. Home health nurses may be assigned to help maintain care. Coastal Vascular & Vein Center, which partners with wound care centers in Charleston, offers walk-in appointments during the week. Addressing a wound early, when it is small, is the “difference in keeping their limb or not,” said Dr. Arthurs. Every centimeter counts. 1327 Ashley River Rd. Charleston, SC 29407 2575 Elms Center Rd., Ste. 200 Charleston, SC 29406 Zachary M. Arthurs, M.D.
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