Effectiveness of glyceryl trinitrate (GTN) vasodilator patches in peripheral arterial disease

Foot ulceration is caused by a variety of factors including ischemia. GTN is a nitric oxide donor that reliably causes vasodilation, but its potential to improve local vascular supply to at-risk feet has received little attention. When used to supplement standard evidence-basedwound care, transdermal GTN produced rapid ulcerhealing in four cases of non diabetic and diabetic ulcers. Subsequently, a larger study was conducted to investigate the effect of using small doses of GTN for therapeutic neurological and vascular outcomes in people with subnormal toe pressures. GTN may increase vascular toe perfusion and thereby assist in wound care and prophylaxis, and might be considered as an adjunct to other therapy, particularly when wounds fail to heal. Unexpectedly high placebo group responses require repeat investigation.