Peripheral vascular disease is a painful and debilitating condition that has many causes, including hypertension, smoking, diabetes and hyperlipidaemia (Morison, 2006). In this case study the patient had severe peripheral vascular disease and chronic obstructive pulmonary disease and had previously been admitted to hospital to treat leg ulceration and recurrent cellulitis. He had been a heavy smoker (60 per day) only stopping with the onset of his chronic obstructive pulmonary disease.