WHEN WOUNDS DON’T HEAL Seek Treatment Right Away

It all started with a tiny insect bite on Jackie’s left leg, and it led to a surgery that saved her foot and her ability to walk.

When the bug bite didn’t heal after several weeks, she sought help from her primary care physician and underwent wound care from a home health nurse. A radiologist performed an X-ray called an arteriogram, which uses special dye to see inside the arteries. It showed that an artery was blocked in Jackie’s leg. Stents were implanted to open the blockage and restore blood flow.

Despite these procedures and wound care at home, her wound did not heal. In fact, she developed a second wound on the same foot. Additional procedures were performed, but her wound only got worse. “My daughter and my home health nurse were worried,” Jackie said. “They knew I needed help right away.”

When Jackie went to the nearest emergency room for evaluation. She was admitted to the hospital so she could get intravenous (IV) antibiotics to treat the infection that had developed in her foot. Based on her health history and worsening wounds, Jackie was at high risk for complications from infection and was facing the possibility of a below-theknee amputation.

Avoiding Amputation

Dr. Charlie Cheng, board-certified vascular surgeon with Houston Methodist Cardiovascular Surgery Associates at Sugar Land, was called in to evaluate Jackie’s leg. He recognized that her wound was still receiving inadequate blood flow despite previous procedures. An arteriogram revealed a blockage.

“A wound needs a healthy blood supply to heal properly,” Cheng explained. “New blood carries vital oxygen and nutrients to the wound, which are keys to successful healing. A wound that is not getting enough blood takes much longer to heal, and in some cases, may never heal.”

Cheng opened the blockage with a stent, restoring blood flow to Jackie’s foot and the wound quickly began to heal. “I was up and walking around in days,” she said, “and now there’s not even a scar!”

Vascular Disease Prevents Activity And Healing

Patients with diabetes, high blood pressure, high cholesterol or vascular disease can suffer from blockages in their veins or arteries in their legs and feet, leading to inadequate blood flow. This can cause leg pain that limits the ability to to walk and can prevent you from doing activities that you enjoy.

As the disease progresses, it may lead to wound development in the leg and reduce the body’s ability to repair itself in the event of a cut or scratch. Without proper healing, the wound can quickly get worse or infected and may require amputation.

For many patients, treatment for a wound without adequate blood flow isn’t enough. To properly heal the wound and prevent new future wounds, the vascular disease must be addressed in a process called revascularization.

EVALUATION & DIAGNOSIS

Your care begins with an evaluation by a vascular surgeon at Houston Methodist Cardiovascular Surgery Associates. After the exam, your doctor will schedule diagnostic studies to evaluate the vascular disease in your leg. If disease of the arteries or veins is detected, you’ll be scheduled for treatment.

Treatment Options

Available treatment options include:

■ Arteriogram and endovascular procedures for balloon and stenting: Contrast dye and an X-ray allows the surgeon to see the arteries. Procedures, such as balloons or stents, can be used to open the artery and restore blood flow.

■ Open surgical bypass: The surgeon implants a portion of your own vein or a synthetic material to create a bypass around the blockage or narrowing. Once in place, the new bypass restores blood flow.

■ Venous ablation: The surgeon uses a special tube, or catheter, inserted into the damaged vein through a small incision in the leg. This tube is then heated with a laser or radio waves to close the vein. Blood is then diverted into a normal vein, improving flow.

“Our vascular surgeons are experts in both bypasses and endovascular procedures, so we are able to offer a customized solution for each patient based on their unique needs,” Cheng noted.

DON’T DELAY CARE

Because of the nature of leg wounds and the role vascular disease plays in delaying healing, it’s important to act quickly and see a specialist who can begin treatment as soon as possible. Doing so can help prevent further tissue damage or amputation. If you have leg pain, treatment can improve your lifestyle and allow you to return to activities you enjoy. •