Peripheral Ischaemia

Patient Information Leaflet

What is Peripheral Ischaemia?

Peripheral Ischaemia is when blood vessels called arteries that carry blood to your legs and feet become narrowed and hardened. This reduces the amount of blood flowing to skin and muscles in your leg and foot.

If your skin becomes damaged it can take a long time to heal. Sometimes the skin may not heal at all, and a foot ulcer will develop.

A narrowed artery can also become blocked and stop blood flow altogether, causing gangrene. These events increase the risk of foot surgery and limb loss.

This damage can occur and spread very slowly, and you may not notice it happening until you have an assessment or develop a problem.

Who is most at risk?

Peripheral ischaemia can be a complication of diabetes, especially if you:

• have found it difficult to keep your diabetes controlled
• have high blood pressure
• have high levels of cholesterol in your blood
• smoke
• have a family history of ischaemia

What are the symptoms?

• Colour changes to your legs and feet.
• Pain in the feet, legs or buttocks at rest or whilst walking.
• Skin on the legs and feet can become thin and very dry.
• Foot and leg hair may disappear.
• Skin is more likely to become damaged.
• Feet and toes may feel cold and become pale or bluish.

How is it treated?

• Medication for reducing high blood pressure, blood sugar and cholesterol can slow progression. Often anticoagulants (blood thinners) may be prescribed to keep blood flowing.
• Surgical procedures to reduce or bypass narrowing and blockages are appropriate for some individuals.
• Safe self-care and monitoring.

Look after your health

• Take your medication and eat a balanced healthy diet.
• Try to do some regular activity such as walking. This helps to keep the blood flowing and make the most of the blood vessel flow you have.
• Stop smoking – this is one of the most important things you can do

Be “foot aware”

• Look for changes in the colour and temperature of your skin.
• Monitor any changes in pain levels.
• Think about what could have caused the problem and remove the cause.
• Ask someone to check your feet for you if it is difficult.

Looking after your feet

• You may need a podiatrist to give you advice and help with foot care. If a nail is rough or sharp, ask someone to gently file it with an emery board
• Use a moisturising cream daily to keep skin in good condition but avoid applying in between the toes as this can encourage fungal infections.
• Never use sharp implements or corn plasters.

Take care with footwear

• Have your feet measured to ensure shoes fit you correctly as footwear that is too large or too small can cause problems.
• Choose shoes the same shape as your foot – cramped toes are at greater risk of injury
• Full coverage footwear, rather than sandals, provide more foot protection
• Avoid unnecessary seams on footwear or hosiery
• Be cautious when wearing new shoes and slippers – gradually increase the wear time and look out for signs of pressure and friction.
• Avoiding skin damage and trauma should be your priority

Where can I get further advice and support?

Attend your podiatry appointments and contact us if you are concerned

Diabetes UK  www.diabetes.org.uk

The Circulation Foundation  www.circulationfoundation.org.uk

Spotting a foot attack

• Is your foot red, warm or swollen?
• Is there a break in the skin or any discharge (or oozing) on to your socks or stockings?
• Do you feel unwell?

You may not have pain even with a visible wound.

Contact your GP, podiatrist or nurse immediately (or a member of the Foot Protection Service). If they are unavailable, go to your nearest out of hours healthcare service or your A&E department.

If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.

If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

Originator: Hannah Dodd  Date originated: Sep 2024. Review date: June 207 Version: 1. DGH ref.: DGH/PIL/02219