A wound is an open sore which is slow to heal. It can occur anywhere on the foot or leg. On the foot, wounds generally tend to occur on the bottom and may persist due to continued pressure. On the leg, wounds tend to occur due to excessive swelling. However, there are numerous other ways they can occur. Once these wounds begin, they can be a real challenge to heal. The main reasons are listed below.
Most common reasons why wounds don't heal:
Insufficient blood flow/circulation to the lower extremities.
Poor circulation does not allow for important healing factors within the blood stream to reach the wound.
Pressure on the wound.
Either caused by poor shoe gear or internal issues (such as a prominent bone on the bottom of the foot).
Infection within the wound.
Bacteria prevents the growth of healthy tissue, and in fact can 'eat away' at good tissue. It also creates an acidic environment for the wound which further prevents healing.
High blood sugar and A1c levels hinders the ability of the body to heal wounds. On top of that, the associated neuropathy/numbness may prevent a Diabetic from noticing the wound.
Symptoms include drainage and pain. If you have some degree of neuropathy in the feet or legs, the absence of pain will hide early warning signs and allow the wound to develop. If left untreated, wounds can lead to infections, which in turn lead to amputations and can be fatal (sepsis).
We are very experienced with wound care. Typically, conservative therapy is used with a combination of wound debridement (removing any non-viable portions and allowing fresh blood to flow into the area for better healing) and wound products (designed to assist in the wound healing process). Depending on the depth of the wound, we also may use wound vac therapy for deep wounds (suctions out all the drainage to help with heal). We also employ offloading techniques to relieve pressure (for pressure wounds). In some cases, the wound may need extra attention outside of the office. We work closely with home health care who employ a team of experienced nurses specializing in wound care to help with dressing changes between office visits. In other scenarios (such as a bad infection or excessive bony prominence), surgical debridement or treatment may be needed. In addition, we also work closely with other physicians, such as primary care/endocrinology (for better Diabetic control) and vascular surgery (to help improve blood flow to the feet and legs).
We typically like to see our wound patients about once a week until the wound is healed. After the wound heals, we like to work on preventative methods so that the wound does not reoccur. This includes Diabetic shoes, offloading/custom shoes, braces, or compression therapy to name a few. Like almost everything in medicine, the sooner the treatment begins, the better the outcome will tend to be. If you have a wound, or suspect you may have one, please get in touch with us ASAP.