Vascular diagnostic testing of an extremity to measure arterial inflow, venous outflow, and tissue and skin oxygen levels is essential in the care of chronic wounds to be certain they have adequate circulation and oxygen delivery to heal.
This is because non-healing or poor/slow healing of lower extremity wounds often occur due to diabetes and peripheral arterial disease (PAD), which can exist alone or very commonly together. Venous insufficiency and lower extremity swelling can also be a cause of chronic wounds.
It is self-evident that therapy must be correctly targeted, whether it be local debridement and treatment of infection by a podiatrist or wound specialist, improvement in circulation with the help of a vascular surgeon, or improvement in local oxygen delivery with hyperbaric oxygen.
The wound care team usually consists of a podiatrist, a vascular surgeon, and providers at a wound care center. For the team to make a diagnosis, prompt, convenient, accurate, and reproducible vascular testing is needed. These exams screen for arterial disease and venous insufficiency and can also measure tissue oxygen levels in or near wounds.
Inconveniently, this vascular testing and diagnostic process is often fragmented. Patients may need multiple appointments at different locations, results may be delayed, and documentation can vary. Limb preservation is a team effort, but without a timely and accurate vascular diagnostic picture, the care team cannot perform to its fullest.
An onsite vascular diagnostics and testing program is an integrated approach that can improve time-to-diagnosis and patient outcomes. When arterial and venous testing takes place onsite at a podiatrist’s office, a wound care center, or within a vascular surgery department, patients benefit from increased access and faster diagnosis.
By partnering with a dedicated vascular diagnostics and testing provider such as Mint Medical, podiatrists, wound care centers, and vascular surgeons can provide better care for patients.
Vascular Diagnostics for Lower-Extremity Wounds
A patient may come into a podiatrist’s office with a foot wound needing a diagnosis. There are a variety of questions to be asked and answered: is the wound acute or chronic? Does the patient have known diabetes or arterial or venous disease? The patient’s history and physical exam can help answer these questions, but a complete diagnosis and treatment plan must involve specialized vascular testing that might include:
- ABI with and without exercise
- Toe-Brachial Index (TBI)
- Segmental limb pressures
- Doppler waveform analysis
- Pulse volume recording (PVR)
- Lower-extremity arterial duplex ultrasound
- Bypass graft and stent surveillance
- Venous insufficiency studies
- Transcutaneous oximetry (TcPO₂)
- Skin perfusion pressure (SPP)
Mint Medical can perform all these exams.
The Limits of Offsite Vascular Diagnostics
A podiatrist’s office or wound care center without onsite vascular testing and diagnostics faces additional barriers to patient care. A patient with mobility issues may not be willing or able to travel to multiple locations for the different vascular tests needed. In addition, offsite vascular testing could be located in a high-volume hospital where capacity is limited.
It also takes an extra layer of coordination between the care team and the offsite vascular diagnostics team to get a full arterial picture and determine next steps. Delays and lack of cohesive documentation can result in longer time-to-diagnosis and treatment for patients who already need a high level of care.
Wound care for a diabetic foot ulcer includes a full care team with multiple touchpoints; the podiatrist treating the wound, the vascular surgeon managing blood flow, and the wound care team coordinating healing. Again, lower-extremity wounds will not heal without adequate blood flow, so the arterial and tissue-level testing provided by vascular diagnostics is key.
Improving Wound Care with Onsite Vascular Diagnostics
The most efficient and effective way to get a full vascular picture and rapid diagnosis is onsite vascular testing. With a trusted vascular testing partner, podiatrists and wound care centers can implement high-quality onsite vascular testing. With Mint Medical, onsite testing can be performed with a flexible schedule that works well for both physicians and patients.
Mint Medical, a leader in vascular diagnostics for more than 20 years, has the extensive expertise and experience to provide these onsite services. From pinpointing the location and severity of arterial inflow disease to documenting the amount of oxygen reaching the wound bed using TcPO₂, we offer end-to-end diagnostic capabilities.
Our IAC-accredited programs are staffed by credentialed Registered Vascular Technologists (RVTs) with physician oversight and studies are interpreted in a timely fashion. With rapid, accurate results from Mint Medical, care teams have the data they need to make informed decisions regarding:
- Healing potential
- Qualifications for hyperbaric oxygen therapy
- Amputation-level
- Referrals for revascularization
With Mint Medical, the diagnostic testing that informs these decisions can be conducted onsite, which means patients receive an earlier definitive diagnosis and faster referrals.
What Onsite Vascular Diagnostics Means for Wound Care Programs
- Faster time-to-perfusion status
- Audit-ready vascular documentation behind every claim
- A stronger limb-preservation program
- Closer integration between wound care and vascular surgery
From Fragmented Diagnostics to an Integrated Workflow
When vascular testing and diagnostics are fragmented across multiple locations, providers can face unnecessary delays in obtaining the complete arterial, venous, and perfusion information needed to guide patient care. An onsite vascular diagnostics program can bring this information together to support a more integrated workflow among wound care, podiatry, and vascular surgery.
Mint Medical provides turnkey, onsite vascular diagnostics programs designed to support wound care, limb preservation, and surgical decisions. From physiologic testing and arterial duplex to tissue-perfusion assessment, Mint Medical can help care teams increase patient access and improve outcomes with onsite diagnostics.
Get in touch with us to learn how Mint Medical can help strengthen patient outcomes with onsite vascular diagnostics at your location.
Guest Contributor: Jordan Galerkin
Sources:
- Chronic Wounds: Evaluation and Management. American Family Physician. AAFP. https://www.aafp.org/afp/2020/0201/p159.
