When circulation can't keep up,the wound is the messenger.
Wounds that won't heal often trace back to a circulation problem — peripheral artery disease, chronic venous insufficiency, or both. The wound itself is often the first visible clue that something deeper needs attention.
artery disease (PAD)
venous insufficiency
venous in origin
Two problems,two very different wounds.
Vascular wounds aren't all the same. Arterial and venous wounds have different causes, look different, hurt differently — and respond to very different treatment. Telling them apart is one of the most important things we do at the first visit.
Not enough blood reaching the wound
Peripheral artery disease narrows the arteries carrying oxygen and nutrients to your legs and feet. Without enough flow, tissue can't repair itself. Arterial wounds tend to appear on toes, heels, or pressure points — and improve when the leg is dependent (down).
Blood pooling instead of flowing back
Damaged or weakened vein valves let blood pool in the lower legs. Pressure builds. The skin breaks down. Venous wounds tend to appear above the ankle, weep fluid, and improve with elevation. They're the most common cause of leg ulcers.
Mixed-cause wounds need a careful read
Some patients have both. The treatment that helps one cause can harm the other — compression that's appropriate for venous wounds can be dangerous when arterial flow is compromised. Knowing which is which (or how much of each) is critical.
Arterial vs. venous,side by side.
What we look for, and what each one tells us about the underlying problem.
We work with yourvascular team — not around them.
Vascular wounds heal when circulation is addressed. That's why we coordinate with your vascular surgeon (with your consent), and why we make decisions about compression and dressings based on your actual perfusion — not a default protocol.
Vascular wounds historically sustain a prolonged healing course. That doesn't mean they can't heal. It means treatment has to be calibrated, and adjusted over time as your vascular status changes.
We assess perfusion at every visit. If something looks like it's headed in the wrong direction, we communicate with your vascular surgeon early — not after weeks of waiting to see if the wound improves on its own.
And we don't apply compression by reflex. The wrong amount of compression on an arterial wound can cause real harm. The right amount on a venous wound makes the difference between healing in months and not at all.
- Perfusion assessment at intake — pulse exam, ABI when indicated
- Multilayer wraps with mild compression for venous wounds, calibrated to your status
- Coordination with vascular surgery for revascularization decisions
- Wound care product selection chosen for your wound, not a default
- Adjustments as your vascular status changes over time
The wound isn'tthe only sign.
Vascular problems often announce themselves before a wound shows up. If you're noticing any of these, the wound (if it appears) didn't come out of nowhere — and earlier care means better outcomes.
- Pain when walking that improves with rest (claudication)
- Heavy, achy legs at the end of the day, especially with swelling
- Skin discoloration around the ankles — brown staining or redness
- A wound on your leg or foot that isn't healing in two to four weeks
- Cold, pale, or bluish-tinged extremity
- Hair loss on lower legs, or shiny/thin skin in those areas
Questions worth asking out loud.
Tap any question to expand. If yours isn't here, call us — we answer the phone.
How do I know if my wound is arterial or venous?
Location and pain pattern are the biggest tells. Arterial wounds tend to appear on toes, heels, or pressure points and feel worse when the leg is elevated. Venous wounds usually appear above the ankle on the inner calf, often weep fluid, and feel better with elevation. Pulse exam, skin appearance, and ABI testing help us confirm which one — or both — at the first visit.
Can compression hurt me if I have arterial disease?
Yes — and this is why proper assessment matters. Compression is one of the most effective treatments for venous wounds, but the same compression on a leg with poor arterial flow can compromise circulation further. We don't apply compression by default. We assess your perfusion first, calibrate to your vascular status, and adjust as your circulation changes.
Do I need to see a vascular surgeon first?
Not necessarily. Many patients come to us first, and we coordinate with vascular surgery when revascularization is indicated. If you've already established care with a vascular surgeon, we work alongside them — sharing the wound care load while they manage the underlying vascular disease.
How long do venous leg ulcers take to heal?
Highly variable. Venous wounds historically have a prolonged healing course. With the right compression strategy, dressing selection, and consistent home care (elevation, walking, compression compliance), most heal — though it often takes months rather than weeks.
What's an ABI test?
An ankle-brachial index compares the blood pressure in your ankle to the pressure in your arm. It's a non-invasive, in-clinic test that takes minutes. The ratio tells us how well blood is reaching your lower legs and feet — and whether arterial disease is part of the wound picture.
One wound,several systems.
Vascular and diabetes often travel together — and your daily care matters between visits.
Diabetes & Wound Healing
Diabetes accelerates vascular changes. If you have both, what we treat — and how we coordinate — is different.
Caring for Your Wound at Home
For vascular wounds especially, what you do at home — elevation, walking, compression compliance — moves the needle.
Why Specialized Wound Care
The right circulation assessment, the right compression decision, the right vascular handoff. That's not a side concern — it's our specialty.
Whatever stage you're at,
it's timeto make a plan.
Schedule a free 15-minute inquiry call. We'll listen, ask the right questions, and tell you honestly whether we're a fit. No pressure, no hour-long visit.