Chronic Wound Care: When to See a Vascular Specialist vs. Your Primary Doctor

January 2026

A scrape on your knee or a small cut on your hand usually heals without much thought. But when a wound lingers for weeks—or keeps reopening—it’s a different story. Chronic wounds aren’t just frustrating. They can signal an underlying medical issue that needs more than basic care.

If you or a loved one has a wound that isn’t healing, you may wonder: Should I see my primary care doctor, or do I need a vascular specialist? Understanding the difference can help you get the right care sooner—and prevent serious complications.

What Is a Chronic Wound?

A wound is generally considered “chronic” if it hasn’t shown meaningful improvement within four weeks, or hasn’t fully healed within eight weeks. These wounds often stall during the healing process due to poor circulation, infection, diabetes, or other underlying health conditions.

Common types of chronic wounds include:

• Diabetic foot ulcers 
• Venous leg ulcers 
• Arterial ulcers 
• Pressure injuries (bedsores) 
• Non-healing surgical wounds 

While surface treatment matters, the real issue often lies beneath the skin.

The Role of Your Primary Care Doctor

Your primary care physician (PCP) is usually the first stop when you notice a wound that isn’t healing properly. That’s a good place to start.

A primary doctor can:

• Evaluate the wound and check for signs of infection 
• Prescribe antibiotics if needed 
• Manage underlying conditions like diabetes or high blood pressure 
• Provide basic wound care instructions 
• Refer you to a specialist if healing stalls 

For minor wounds or early-stage concerns, this approach is often enough. But if there are signs of circulation problems, a deeper evaluation may be necessary.

When Poor Circulation Is the Real Problem

Wound healing depends heavily on blood flow. Oxygen and nutrients travel through your arteries to repair damaged tissue. If circulation is compromised, healing slows—or stops altogether.

This is where a vascular specialist becomes essential.

Vascular specialists focus on diagnosing and treating diseases of the blood vessels. When wounds are caused by venous insufficiency, peripheral artery disease (PAD), or other circulation disorders, treating the wound alone isn’t enough. The underlying blood flow issue must be addressed.

Signs You Should See a Vascular Specialist

If you notice any of the following, it may be time to seek vascular care:

• The wound has not improved after several weeks 
• The area around the wound feels cool or looks pale 
• You experience leg pain while walking (claudication) 
• Swelling in the legs accompanies the wound 
• The wound is deep, enlarging, or producing drainage 
• You have diabetes and the wound is on your foot 
• Skin around the wound appears dark, shiny, or thickened 

These symptoms can indicate venous disease or arterial blockages that require advanced imaging and specialized treatment.

Venous vs. Arterial Ulcers: Why It Matters

Not all chronic wounds are the same. Identifying the cause determines the treatment plan.

Venous Ulcers

Often located around the ankle, venous ulcers are linked to chronic venous insufficiency. They may appear shallow, with swelling and skin discoloration nearby. Treatment typically includes compression therapy and procedures to improve vein function.

Arterial Ulcers

These wounds are usually found on the toes, feet, or lower legs. They may look punched-out and painful. Arterial ulcers result from reduced blood flow due to blocked arteries. Treatment may involve restoring circulation through minimally invasive vascular procedures.

A vascular specialist uses diagnostic tools like duplex ultrasound or vascular imaging to pinpoint the cause.

Why Early Referral Matters

Waiting too long to escalate care can increase the risk of infection, hospitalization, or even limb loss in severe cases. Early vascular evaluation can:

• Identify blocked or damaged blood vessels 
• Improve circulation through minimally invasive procedures 
• Reduce the risk of amputation 
• Speed up healing time 
• Prevent recurrence 

The earlier the underlying problem is addressed, the better the outcome.

Collaborative Care Is Often the Best Approach

In many cases, chronic wound care is a team effort. Your primary doctor may continue managing your overall health, while a vascular specialist addresses circulation issues. Wound care nurses and specialists may also play a role in ongoing treatment and monitoring.

This coordinated approach ensures that both the surface wound and its root cause are treated effectively.

Don’t Ignore a Wound That Won’t Heal

It’s easy to assume a wound just needs more time. But when healing stalls, your body may be signaling something more serious.

If your wound hasn’t improved within a few weeks—or if you have diabetes, vascular disease, or persistent leg symptoms—ask whether a vascular evaluation is appropriate. A simple test could uncover a treatable circulation issue that’s preventing healing.

Chronic wounds are rarely just skin-deep. Getting the right specialist involved at the right time can make all the difference in protecting your health and mobility.