Why Do Foot and Leg Wounds Not Heal?

Why do some wounds just not heal? It's a complicated question, and a chronic wound is defined as a wound which lasts more than four weeks. A lot of the time these are systemic issues: either it's nutrition, smoking, diabetes or certain medications. But from a vascular perspective, there are really two things I worry about. Is it an arterial problem, or is it a venous problem? Because most of the time these go undiagnosed.

Arteries, as I said, pump fresh blood straight to the wound, and you really do need that fresh blood in order for wounds to heal. So if there are blockages or narrowings and the blood supply is inadequate, the wound will not heal. Similarly, but by a different mechanism, if the venous system is compromised, the valves aren't working and you have venous reflux, then the back pressure of that venous system pushes into the wound bed and can cause problems and delay wound healing as well.

So if you have a chronic wound and it hasn't healed, maybe you need to see a vascular surgeon and get both your arterial and venous systems looked at and investigated.