The April Research Roundtable explored the complex relationship between lymphedema, peripheral arterial disease (PAD), and chronic wound healing, highlighting why clinicians need to look beyond the surface when evaluating a wound.
Special guest Dr. M. Mark Melin joined host Dr. Karen Herbst to discuss how lymphatic dysfunction is present in nearly every chronic wound, particularly in the surrounding tissues. Even when pulses are detectable, swelling and inflammation around the wound can impair microcirculation, limiting the delivery of oxygen and nutrients and slowing healing.
A key takeaway: effective wound care isn’t just about treating the visible wound—it’s about improving the health of the surrounding tissue, reducing edema, and restoring both lymphatic and arterial flow.
The discussion also emphasized how frequently PAD is overlooked. Clinicians should not assume adequate blood flow simply because a foot feels warm or a pulse is detected. The panel recommended routine use of ankle-brachial index (ABI) testing and foot X-rays for patients with lower extremity ulcers, even when wounds appear straightforward.
They also introduced the concept of angiosomes—specific blood vessel territories that supply different areas of the foot—explaining why wounds may fail to heal if the targeted artery is blocked. The group also discussed more advanced testing, like CT angiograms and TcPO₂ measurements, while emphasizing that clinicians should start with the least invasive and most cost-effective options first.
Real patient cases reinforced the impact of this approach. In multiple instances, aggressive edema management and the use of arterial pumps improved circulation, prevented amputation, and even supported the development of new blood vessels (angiogenesis). These therapies are also becoming more widely covered by insurance.
Overall, the conversation underscored the importance of a multidisciplinary approach to wound healing and how addressing edema, lymphatic dysfunction, and circulation together can significantly improve patient outcomes.
Lympha Press offers both intermittent pneumatic compression pumps as well as the ArtAssist arterial pump to treat PAD. Find out more at lymphapress.com.
This Roundtable was originally recorded live on April 6, 2026. The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or positions of Lympha Press. The content is for educational purposes only and not intended as medical advice.
Watch more Roundtables from our Lympha Press Research Roundtables playlist on YouTube.