Symptom Details

People with peripheral vascular disease (PVD) may start out with mild symptoms, or no symptoms. Without treatment, conditions such as varicose veins, tired heavy legs and pain at rest can eventually turn into more severe complications as the disease progresses.

More than 500,000 to 2 million people in the United States suffer from leg ulcers, or non-healing wounds.8 Conditions such as superficial venous insufficiency (SVI) and deep venous disease (DVD) can reduce blood flow to the extremities and can make it difficult for the body to heal itself. These sores usually develop on the leg above the ankle.2

Arterial disease such as critical limb ischemia (CLI) can also cause wounds to heal slowly. This advanced form of arterial disease can result in ulcers below the ankle as well as kissing ulcers, or non-healing wounds between toes.

Non-healing wounds are almost always accompanied by redness, swelling and pain. Left untreated, these sores are at risk of developing an infection, which can lead to serious, long-term health complications, including amputation of the limb.3

Symptoms can range depending on the progression of the underlying PVD disease and how far it has progressed.4,5,6 If you are experiencing any of these symptoms consistently, it is important to take the step and seek help from your doctor right away.

Venous Causes and Symptoms

More than 80 percent of leg ulcers are caused by venous disease.9 When the veins in your legs are not working efficiently to carry blood back to the heart, the valves have become damaged and blood flows the wrong way. This back-up of fluid causes blood to pool in the leg and builds increased pressure on the vein walls. This condition can lead to skin damage and non-healing wounds.

Venous wounds develop above the ankle when the blood pools in the ankles. The leaky veins result in pooling of inflammatory substances in the blood, which in turn irritate the skin chronically and lead to wounds.

  • The skin may thicken and become hard
  • Changes in color, usually black or dark bluish color, around the wound area
  • Swelling and redness may develop
  • Fluid may discharge from the wound
  • A foul-smelling odor may happen

Arterial Causes and Symptoms

Arterial disease can also cause non-healing wounds. As fatty plaque builds up inside the artery, it narrows and restricts blood flow to the limbs. This damage to blood vessels can result in non-healing wounds.

  • Legs that feel fatigued
  • Pain in the affected limb may be felt while sleeping or resting
  • Persistent and increasing pain around the wound area
  • Skin may be cool to touch and hairless
  • Gangrene, or black toe, may also occur

Risk Factors

Not all people with PVD disease will develop non-healing wounds. But there are certain risk factors that can increase the chances of developing the severe condition.

These risks include:7,8

  • Obesity or being overweight can put pressure on your legs and restrict healthy blood flow. Over time skin damage and leg sores may occur
  • Certain medical conditions such as high cholesterol, high blood pressure and diabetes can increase the likelihood of developing non-healing wounds
  • Smoking can damage the veins and their ability to transport blood
  • History of varicose veins can predispose you to developing these types of sores
  • Being older than 60 can increase the likelihood of developing arterial or venous disease

What to Look For

Non-healing wounds usually do not begin on their own. A person may notice swelling, varicose veins, or many other symptoms relating to PVD disease. As the condition advances open sores can develop.

Arterial Signs

The Rutherford Classification is a common system that is widely used to diagnose and identify the severity of arterial disease as it progresses.

Rutherford Classification

Stage 0

No symptoms

Stage 1

Some exercise pain after walking long distances

Stage 2

Exercise pain that occurs more frequently at shorter distances

Stage 3

Severe exercise pain that happens frequently after a short distance

Stage 4

Pain in the legs, calves, buttocks that occurs despite rest

Stage 5

Leg ulcers begin to develop

Stage 6

Severe non-healing wounds can lead to gangrene or tissue loss

non healing wounds

Arterial Ulcer

non healing wounds

Arterial Ulcer

Venous Signs

Non-healing venous wounds, caused by Venous Disease, may present these signs

  • Thick, lumpy skin near the sore
  • Redness or discoloration around the area can develop
  • Swelling in the leg may occur and worsen as the day progresses
  • Ankles may be swollen
  • White colored scarring near the sore
  • Varicose veins may also be present
non healing wounds

Venous Ulcer

non healing wounds

Venous Ulcer

When to See a Doctor

If you have a wound that persists and fails to improve, it is crucial to take the step and seek help. These wounds will not heal on their own without medical treatment. It is important to get properly diagnosed, especially to reduce the risk of infection and long-term complications.

Talk to your doctor, or use our tool to locate a doctor to consult for a diagnosis.

Helpful Resources

PVD Doctor
Discussion Guide

Get helpful tips and advice on how to talk to your doctor about a PVD screening.

Download now

Third-Party Resources

Apps

CardioVisual

A mobile app built by cardiologists, to simplify understanding of most cardiac and peripheral vascular conditions and treatments.

cardio visual app
app store, google play

Find a Doctor

Consult your doctor to learn more about non-healing wounds and how to maintain your vein health. You can also use our tool below to find a specialist near you.

 
Within |
Blaine Borders

102 Thomas Rd. Suite 205 | West Monroe, LA, 71291

Pat Neville

4600 Memorial Dr. Suite 240 | Belleville, IL, 62226

Charles Wyble

61 Witcher Street, Suite 2100 | Marietta, GA, 30060

David Gillespie

363 Highland Ave | Fall River, MA, 2720

Polly Kokinos

2255 S. Bascom Avenue #200 | Campbell, CA, 95008

Howard Roth

23120 South LaGrange Road | Frankfort, IL, 60423

Anthony Avino, MD, FACS

4750 Water Avenue, Suite 500 | Savannah, GA, 31410

Murat Sor

3833 Fairfax Drive | Arlingston, VA, 22205

Mahesh Raju

3825 highland ave | downers Grove, IL, 60515

Kenneth Wright

19189 N Dale Mabry Hwy | Lutz, FL, 33548

Rick Coats

4600 Memorial Dr # 240 | Belleville, IL, 62260

Sendhil Subramanian

7130 Mt. Zion Blvd, Suite #10 | Jonesboro, GA, 30236

Richard Pin

363 Highland Ave | Fall River, MA, 2720

James McPherson

4644 Lincoln Blvd. Suite 500 | Marina del Rey, CA, 90292

Ben Marson

85 Old Kings Highway N, 1st Floor | Darien, CT, 6820

E. Jerry Cohn Jr., MD, FACS

4750 Water Avenue, Suite 500 | Savannah, GA, 31410

George Hemstreet

100 Rice Mine Road Loop | Tuscaloosa, AL, 35406

Harold Tabaie

18905 Sherman Way | Reseda, CA, 91335

Alberto Gonzalez

19189 N Dale Mabry Hwy | Lutz, FL, 33548

Ayaz Malik

1035 Bellevue Ave #500 | St. Louis, MO, 63117

Isabel Newton

200 W Arbor Dr. | San Diego, CA, 92103

Michael Ayad

363 Highland Avenue | Fall River, MA, 2720

Jozsef Lukacs

24800 S.E. Stark St. | Gresham, OR, 97030

Timothy Manoni

85 Old Kings Highway N, 1st Floor | Darien, CT, 6820

Larry Horesh, MD

4750 Water Avenue, Suite 500 | Savannah, GA, 31410

Amiel Moshfegh

11411 Brookshire Ave | Downey, CA, 90241

Lev Pukin M.D

2560 Ocean Ave | Brooklyn, NY, 11229

Parag Patel

6633 Forest Ave #300 | New Port Richey, FL, 34653

Hoang Nguyen

2 Good Samaritan Way Suite 220 | Mt. Vernon, IL, 62864

(Charles) Daniel Procter

725 Jesse Jewell Parkway #125 | Gainesville, GA, 30501

Michael Naumann

7777 Alvarado Road, Suite 108 | La Mesa, CA, 91942

Stephen Lalka

1001 Blythe Blvd., Suite 300 | Charlotte, NC, 28203

Taras Kucher

495 Hawley Lane, Suite 2-A | Stratford, CT, 6614

Junyang Lou

520 Medical Center Drive | Medford, OR, 97504

Michael Lepore

600 North Cattlemen Rd | Sarasota, FL, 34232

Robert Freedman

3311 Prescott Road | Alexandria, LA, 71301

Daniel Simon

347 Mount Pleasant Ave Suite 100 | West Orange, NJ, 7052

Daniel McDevitt

1035 Southcrest Dr, Suite 250 | Stockbridge, GA, 30281

Marvin Padnick

350 South 40th Street | Muskogee, OK, 74401

Patrick Mahon

87 McGregor Street | Manchester, NH, 3102

Jamie Strachan

1449 Old Waterbury Rd, Suite 101 | Southbury, CT, 6488

Aaron Aday

75 Francis St | Boston, MA, 02115

Russell Samson

600 North Cattlemen Rd | Sarasota, FL, 34232

Raghotham Patlola

5003 Hardy St, Ste 200 | Hattiesburg, MS, 39402

Bruce Brenner

200 S. Orange Ave | Livingston, NJ, 7052

Ernest Conti

3929 Mercy Drive | McHenry, IL, 60050

Sanjeev Trehan

6151 South Yale Ave Suite 1304 | Tulsa, OK, 74136

Tara Balint

2010 Health Campus Drive | Harrisonburg, VA, 22801

Stephen Bauer

1445 East Putman Ave, 1st Floor | Old Greenwich, CT, 6870

Deepak Nair

600 N Cattlemen Rd | Sarasota, FL, 34232

David Showalter

600 North Cattlemen Rd | Sarasota, Florida, 34232

Andrew Olinde

5131 O'Donovan Drive 301 | Baton Rouge, LA, 70808

Allison Barone

250 Engle Street | Englewood, NJ, 7631

Thomas Lutz

15 Tower Ct Suite 200 | Gurnee, IL, 60031

Mark Iafrati

800 Washington st | Boston, MA, 2111

Jerry Chen

2775 Laurel Street, Room 4203 | Vancouver, BC, V5Z1M9

Jonathan Bowman

495 Hawley Lane, Suite 2-A | Stratford, CT, 6614

Paul Vitulli

915 W Monroe St | Jacksonville, FL, 32004

Douglas Dorsay

600 North Cattlemen Rd | Sarasota, Florida, 34232

Carl Fastabend

501 Dr. Michael DeBakey Drive (3rd Floor) | Lake Charles, LA, 70601

Thomas Lee

131 Madison Avenue 2nd Floor | Morristown, NJ, 7960

Peter Swischuk

3109 Stirling rd. Suite 100 | Fort Lauderdale, FL, 33312

David Draughn, FACS, RVT, RPVI

15825 John J Delaney Dr | Charlotte, NC, 28277

Joe Viramontes

960 N 16th Street Suite 108 | Springfield, OR, 97477

Michael Sergi

75 Kings highway Cutoff, Suite 4B | Fairfield, CT, 6824

Manish Chauhan

2200 Park bend | Austin, TX, 78757

James Cunningham

8767 Perimeter Park Blvd | Jacksonville, FL, 32216

Nouri Al-Khaled

4400 W 95th Street, Suite 306 | Oak Lawn, IL, 60453

Cindy Sturt

200 S. Orange Ave | Livingston, NJ, 7039

Jesus Jimenez

2800 S Seacrest Dr. Suite 200 | Boyton Beach, FL, 33435

Andrei Pop

800 Biesterfield Road | Elk Grove Village, IL, 60007

Ediberto Soto-Cora

1139 Caper Rd | El Paso, TX, 79925

Kaveh Shahmohammadi

1449 Old Waterbury Rd, Suite 101 | Southbury, CT, 6488

Lori Pounds

7703 Floyd Curl Drive | SanAntonio, Texas, 78229

Alex Caballero

1879 Nightinglae Ln | Tavares , Florida, 32778

Thomas Levin

10837 South Cicero Avenue Suite 200 | Oak Lawn, IL, 60453

Leandro Perez

8188 Jog Rd. Suite 100 | Boyton Beach, FL, 33427

Jose Almeida

1501 S Miami Ave. | Miami Beach, FL, 33129

Saba Khan

800 Biesterfield Road | Elk Grove Village, IL, 60007

Jordan Knepper

5325 Elliot Drive, Suite 101 | Ypsilanti, MI, 48197

Jason Andre

12720 McManus Blvd, Suite 303 | Newport News, VA, 23602

Micheal Ayad

300A Faunce Corner Rd N | Darthmouth, MA, 02908

Yazan Khatib

Suite #160, FL, 32256

Santhosh Mathews

316 Manatee Ave W | Bradenton, FL, 34205

Patricio Rosa

601 N Flamingo Rd. Suite 408 | Pembroke Pines, FL, 33028

Akhilesh Sista

2315 Broadway 4th floor | New York, NY, 10024

Kathleen Gibson

1135 116th Avenue NE, Suite 305 | Bellevue, WA, 98004

James Sampson

101 Bodin Circle 60 SGCS/SGCH | Travis AFB, CA, 94535

Brian Heeringa

880 Munson Ave, Suite A | Traverse City, MI, 49686

Ravi Chandra

1920 SW 20th Place | Ocala, Florida, 34471

Vaqar Ali

7011 AC Skinner Parkway | Jacksonville, FL, 32256

David Burkart

4801 College Blvd | Leawood, KS, 66214

Asad Sawar

3010 E. 138th Avenue Suite 12 | Tampa, FL, 33613

Andrew Barleben

9434 Medical Center Dr. | La Jolla, CA, 92037

Gennady Geskin

6637 State Route 30 | Jeannette, PA, 15644

William Grande

8200 east Belleview Ave Suite 600e | Greenwood Village, CO, 80111

Jeffrey Carr

1783 Troup Highway | Tyler, TX, 75701

Vincent Digiovanni

Riddle Health Center 3, 1098 W Baltimore Pike, Suite 3308 | Media, PA, 19063

Ido Weinberg

55 Fruit St | Boston, MA, 02114

Dale Buchbinder

1212 York Road | Lutherville, MD, 31093

Paul Gagne

85 Old Kings Highway North | Darien, CT, 6820

Vasco Marques

3010 E. 138th Avenue Suite 12 | Tampa, FL, 33613

Scott Koss

725 American Ave | Waukesha, WI, 53188

Janardhan Srinivasan

2232 Wilborn Avenue | South Boston, VA, 24592

Steve Lin

1401 Harrodsburg Rd Ste A300 | Lexington, KY, 40509

Kais Yehyawi

6375 W US 6 | Portage, IN, 46368

Diego Hernandez

43700 Woodward Avenue, Suite 207 | Bloomfield Hills, MI, 48302

Deepak Sudheendra

3400 Spruce Street | Philadelphia, PA, 19104

Fuad Rafidi

23101 Sherman Place | West Hills, CA, 91307

Thomas Kerr

19189 N Dale Mabry Hwy | Lutz, FL, 33548

Hesham Fakhri

3010 E. 138th Avenue Suite 12 | Tampa, FL, 33613

Aaron Hurd

630 13th Street Suite 250 | Augusta, GA, 30901

Sunil Rayan

9850 Genesee Ave | La Jolla, CA, 92037

David Lipski

6420 Dutchmans Pkwy Suite 180 | Louisville, KY, 40205

Rias Ali

4740 Mile Stretch Drive | Holiday, FL, 34690

Jed Peterson

10123 SE Market Street | Portland, OR, 97216

Constantino Pena

8900 North Kendall Drive | Miami, FL, 33176

Zahi Nassoura

2710 Alameda Ave | Burbank, CA, 91505

Nader Chadda

6633 Forest Ave Ste 302 | New Port Richey, FL, 34653

Richard Ofstein

8075 N Shadeland Ave Ste 200 | Indianapolis, IN, 46037

Robert Davies

1301 Sigman Road, NE Suite 130 | Conyers, GA, 30012

Elizabeth Brooke Spencer, MD, FSIR

8200 east Belleview ave Suite 600 E | Greenwood Village, CO, 80111

Mazen Abu-Fadel

825 NE 10th St #2500 | Oklahoma City, OK, 73104

David Frankel

10666 N. Torrey Pines Rd. | La Jolla, CA, 92037

Patricia Thorpe

333 W Thomas Rd, Suite 207A | Phoenix, AZ, 85013

Peder Horner

1746 Cole Boulevard | Lakewood, CO, 80401

Fuad Rafidi

2710 | Burbank, CA, 91505

Gene Tanquilut

20060 Governors Drive Suite 102 | Olympia Fields, IL, 60461

Kannan Natarajan

8433 Harcourt Rd. Suite 100 | Indianapolis, IN, 46260

Charles Ross

95 Collier Road NW Suite 5015 | Atlanta, GA, 30309

Windsor Ting

1468 Madison Avenue or 1190 Fifth Avenue | New York, NY, 10029

Dev Mangalat

705 Jesse Jewell Parkway 125 | Gainseville, GA, 30501

Arun Jagannathan

23120 South LaGrange Road | Frankfort, IL, 60423

Michael Flisak

3231 South Euclid Avenue, Suite 207A | Berwyn, IL, 60402

Shahin Pourrabbani

3680 Imperial Highway | Lynwood, CA, 90262

Joe Viramontes, MD

960 N 16th Street | Springfield, OR, 97477

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1. Iqbal et al. “Management of Chronic Non-healing Wounds by Hirudotherapy.World Journal of Plastic Surgery. 2017 Jan; 6(1): 9–17.

2. Hess, Thomas. “Checklist for Factors Affecting Wound Healing.Advances in Skin & Wound Care: April 2011 – Volume 24 – Issue 4 – p 192.

3. Guo et al. “Factors Affecting Wound Healing.J Dent Res. 2010 Mar; 89(3): 219–229.

4. Frykberg et al. “Challenges in the Treatment of Chronic Wounds.Adv Wound Care (New Rochelle). 2015 Sep 1; 4(9): 560–582.

5. “6 Signs You Have an Infected Wound.” Advanced Tissue. n.d.

6. Walshe C. “Living with a venous leg ulcer: a descriptive study of patients’ experiences.J Adv Nurs. 1995 Dec;22(6):1092-100.

7. Grey et al. “Venous and arterial leg ulcers.BMJ. 2006 Feb 11; 332(7537): 347–350.

8. Margolis DJ, Bilker W, Santanna J, et al. “Venous leg ulcer: incidence and prevalence in the elderly.J Am Acad Dermatol 2002;46(3):381-6. PMID: 11862173

9. Simon et al. “Management of venous leg ulcers.BMJ. 2004 Jun 5; 328(7452): 1358–1362.

10. Hardman et al. “Overview of Classification Systems in Peripheral Artery Disease.Semin Intervent Radiol. 2014 Dec; 31(4): 378–388.

Disclaimer

The opinions and clinical experiences presented herein are for informational purposes only. Individual results may vary depending on a variety of patient specific attributes and related factors. Dr. Raghu Kolluri has been compensated by Philips for his services in preparing and providing this material for Philips further use and distribution.

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