A Wound That Wonât Heal? Check Blood Flow First
A wound that will not heal may need more than dressings. Dr Andrew Choong explains when to check blood flow, which tests may help and how circulation can change the treatment plan.
A foot or leg wound that is slow to heal may need a blood-flow assessment, particularly if you have diabetes or known poor circulation. Dressings help protect a wound, but they cannot correct an arterial blockage. The important question is whether enough blood is reaching the tissue to support healing.
In this video, Dr Andrew Choong, vascular and endovascular surgeon in Singapore, explains why circulation should be considered alongside wound care, especially before major decisions such as amputation.
Why might a wound fail to heal?
Peripheral arterial disease (PAD) narrows or blocks the arteries supplying the legs. When blood supply is inadequate, a wound may remain open despite repeated dressings. Infection can add to the problem, and antibiotics may be needed when infection is present.
Not every slow-healing wound is caused by an arterial blockage. Assessment needs to establish the cause and address the wound itself as well as circulation. Recurrent wounds, increasing pain, black tissue or a wound in someone with diabetes deserve early attention.
What does a blood-flow assessment involve?
A vascular assessment starts with the history, examination of the wound and checking pulses. Depending on the findings, tests may include:
A handheld Doppler to assess blood-flow signals.
Ankle or toe pressure measurements to help assess circulation.
Duplex ultrasound to map arterial narrowing and flow.
CT angiography or other imaging when more anatomical detail is needed.
The tests answer different questions. Not everyone needs every scan; the investigation should help guide a useful treatment decision.
Can improving circulation help the wound?
For selected patients with threatened tissue from poor arterial supply, restoring blood flow can support healing and help preserve a functional limb. Options may include angioplasty and stenting or leg bypass surgery, depending on the anatomy, previous treatment and overall health.
A procedure does not guarantee healing or avoidance of amputation. Diabetic foot and wound care remains essential, and some people need a different treatment plan. Circulation assessment helps make that discussion better informed.
When should I seek urgent help?
Do not wait for a routine appointment if a foot suddenly becomes severely painful, cold, pale or numb, or develops new weakness. Seek emergency care; call 995 in Singapore. Worsening wound redness, discharge, fever or new pain at rest needs prompt clinical assessment.
Arrange an assessment in Singapore
For a planned review, contact Andrew Choong Vascular Surgery at Mount Elizabeth Novena Specialist Centre. Bring previous scan reports, wound-treatment records and your medication list. You can also watch the blood-flow and wound-healing video or explore the leg circulation video collection.