Wounds/Ulcers

Foot ulcers are open and vulnerable lesions that, similarly to a corn or callus, will not heal themselves. These can be caused by a large number of things, including but not limited to untreated calluses, blisters, poor circulation, or genetics. Patients who are diagnosed with diabetes, circulatory or clotting disorders, kidney failure, or lymphedema are at a higher risk for developing severe and infected ulcers. Ulcers can develop anywhere on the body. If you find one below your knee, contact your podiatrist for a mitigation plan to avoid severe infection.

This is different from a laceration. An ulcer is a chronic, non-healing wound. A laceration can turn into an ulcer, if untreated.

Symptoms

There are different types of foot ulcers, depending upon the severity and location of the wound, and the patient’s previous medical history. See the chart below for the varying symptoms and appearances of neurotrophic and arterial ulcers.

Neurotrophic (Diabetic) Ulcers

Arterial (Ischemic) Ulcers

  • Base is pink, red, brown or black,
    depending on circulation.
  • Borders are faint, or even recessed
    the normal skin level.
  • A lack of sensation in the feet, also
    known as neuropathy, makes feeling
    ulcers difficult for diabetic patients.
  • Yellow, brown, grey or black border
  • Does not bleed
  • Borders are faint
  • Skin is patchy surrounding the border

Symptoms

  • Burning
  • Itching
  • Swelling
  • Discoloration
  • Dry, scaly skin
  • Painful, especially at night

Progression

Wounds want to heal themselves, but don’t always have the resources to do so quickly. Meaning, the body might not be producing enough “good material “ to combat the bacteria, and repair the wound. After an ulcer is acquired, there are four different stages to the healing process.

Beginning with the hemostasis phase; essentially, the wound is attempting to produce a scab to close the wound. Oftentimes, the body will not be able to close this wound on its own. Next comes the inflammatory phase, this is where your podiatrist will remove bacteria and debris from the wound. Most swelling and leaking from the wound happens during this stage. After the foreign matter has been expelled from the site, we enter the proliferative phase. This is the beginning of regeneration, where the cells begin to produce disorganized collagen, the wound contracts as new tissue is created surrounding it. The final phase is the maturation phase, where the collagen becomes more organized in the wound, allowing for a weaving-like pattern. At this point, the wound is on the road to a successful healing.

Nonsurgical Treatment

  • Antibiotics to prevent infection.
  • Compression garments.
  • Debridement– Removing the dead material on the top of the ulcer will promote healthy and regular skin growth, eventually healing the wound.
  • Dressing the wound– There are many different types of dressings, your podiatrist will assess the ulcer and determine which type is the best fit.
  • Wound grafts– We offer a variety of advanced wound care treatments targeted at helping to close wounds to prevent further spread or infection. It’s a quick application process in the office that can be repeated weekly, if necessary. Make an appointment today to discuss the possibility of skin grafts.