Foot and Ankle Wounds

Updated 11/15/2022
Foot Wound Care, University Foot and Ankle Institute of Los Angeles

Are you worried about a non-healing wound on your foot?

Skin is your body’s first line of defense against infection. Wound care is far more than fixing a wound; it is a process of investigating why a wound is not healing.

 

There are many reasons wounds do not heal ranging from ulcers (often due to diabetic wounds) to circulation problems to uneven foot pressure distribution and deformities, to name just a few.

 

Wound care management is a highly technical process requiring expert analysis and treatment.

What types of foot and ankle wounds do podiatrists treat?

Our podiatric wound care specialists can treat lower extremity wounds including:

 

Ulcers

An ulcer is a lesion that develops on the skin, typically as a result of an infection. Ulcers are characterized by a deep crater-like sore, which is often painful and may bleed. Ulcers most commonly found on the legs, feet, and toes include pressure ulcers, diabetic ulcers venous leg ulcers, and ischemic ulcers.

 

If left untreated, ulcers can lead to serious complications, including infection and tissue death. Treatment typically involves a combination of antibiotics and wound care.

 

If left untreated, ulcers can lead to serious complications, including bone infections (osteomyelitis) and tissue death. Treatment typically involves a combination of antibiotics and wound care.

 

Diabetic foot ulcers can also be a marker of a more serious underlying medical condition. According to the American Diabetes Association, diabetic ulcers are associated with peripheral arterial disease, heart attack, stroke, renal disease, nerve damage, and even amputation. More than 60% of lower-limb amputations occur in diabetic patients, and a foot ulcer precedes 85% of these amputations. 

 

Comprehensive programs providing diabetic foot wound care for foot and leg ulcers have been shown to reduce lower extremity amputation rates by up to 85%. Read more about foot ulcers here.

 

Surgical wound complications

There are a number of reasons why a wound may not heal properly after surgery. The most common reason is infection. If the wound is not kept clean, bacteria can enter and cause an infection. This can delay healing or even lead to further complications.

 

Other factors contributing to non-healing surgical wounds are poor circulation, diabetes, and radiation therapy. If the blood supply to the area is insufficient, the wound will not heal as quickly. Diabetes can also interfere with wound healing. Radiation therapy can also damage the cells needed for healing, making it more difficult for the wound to close and causing neuropathy.

 

Puncture wounds

A foot puncture wound is a wound that penetrates the skin and underlying tissues of the foot; it is a serious injury that can lead to infection and other complications. The most common causes of foot punctures are sharp objects, such as nails or glass. Animal bites also cause puncture wounds.

 

Treatment of a foot puncture wound includes cleaning the wound, applying antibiotic ointment, and wrapping the wound in a sterile bandage. If the wound is deep, it may require stitches. Read more about puncture wounds here.

 

Traumatic injuries

Various types of traumatic injuries can occur, including lacerations, abrasions, animal bites, and damage caused by blunt force trauma. Since traumatic wounds can vary in severity and cause, treatment can also vary.

 

No matter the cause or severity of the wound, it is important to seek medical attention as soon as possible. Time-sensitive medical care ensures the wound is properly treated and won’t become infected.

 

Abscesses

An abscess is a pus-filled pocket that forms in response to an infection. The infection can be bacterial, viral, or fungal and, if left untreated, can spread and cause serious health problems. Abscesses can be painful and may require treatment with antibiotics or surgery.

 

Infected corns and calluses

Corns and calluses can be very painful and become infected if not treated. Symptoms of infected corn or callus include redness, swelling, pain, and drainage of pus.

 

If you have any of these symptoms, you must see a doctor immediately. If the infection is left untreated, it could lead to serious complications, such as cellulitis or blood poisoning.

 

Complications from peripheral arterial disease

Those with poor circulation due to peripheral arterial disease (PAD) often need special care when it comes to healing wounds. If you have PAD, your blood vessels are narrowed or blocked, which can reduce blood flow to your limbs and inhibit wound healing. PAD can lead to serious complications, such as infections, ulcers, and gangrene.

 

Skin tears

Skin tears can be serious injuries that cause the outer layers of the skin to partially or fully separate. They can happen due to shearing and friction forces or from a blunt blow. Although skin tears are sometimes considered minor injuries, they can cause complications like infection, problems with veins, and serious health problems.

 

The elderly and those dependent on others are more susceptible to developing skin tears. With age, skin becomes thinner and loses elasticity, making it more fragile and prone to tears with even a bump or fall. Patients with a poor diet or those taking certain medications (including steroids) are also at a greater risk. 

 

Burns

Fire, boiling water, hot metal, and certain chemicals can easily burn skin. Footwear will usually protect your feet from this kind of damage, but shoes won’t completely remove your risk. No matter the severity of the burn, it's important to treat it as soon as possible to prevent further damage and begin the healing process.

 

Fungating Tumors

Some cancers, like skin cancer and radiation-treated cancers, may develop into open wounds in the skin. These open wounds — often called ulcerated cancer wounds or fungating tumors — are tumors that grow to the point that they break through the skin. Treatments range from gentle debridement to surgical procedures.

 

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Wound care treatment options 

Our foot and ankle providers have a track record of great success in healing wounds that were considered untreatable in the past. We utilize leading-edge technology such as gentle shock wave therapy, hyperbaric oxygen therapy, wound VAC therapy, and regenerative medicine treatments like amniotic membrane grafts.

 

When more traditional foot wound treatment modalities are indicated, our specialists have extensive experience performing debridement, skin grafts, rotational muscle flaps, complex wound closures, and, if necessary, limb salvage procedures.

 

What to expect at your first wound care appointment

Our process begins with X-rays, advanced MRI, and CT scanning of the foot and ankle. These imaging tests are followed by pressure analysis. If there is excess pressure on a region from a bunion, hammertoe, improperly cut toenails, or other foot problems, we will find the cause.

 

We can correct simple pressure distribution with an orthotic or custom insole to protect the high-pressure region. A custom orthotic spreads the pressure across more areas of the foot — which reduces stress and helps with wound healing.

 

Why seek out a podiatry expert to treat foot wounds? 

It is critically important to seek a foot and ankle specialist (also known as a DPM) who can determine the cause of the wound or ulceration and design an appropriate treatment plan using the latest technologies for treating chronic wounds.

 

A wound examination involves looking at your condition from four key vantage points:

1. Vascular — blood circulation

2. Dermatologic — skin integrity

3. Orthopedic — bones, muscles, and ligaments

4. Neurologic — condition of the nerves

 

Expertise in these key areas and lower extremity biomechanics, structural deformities, skin substitutes, and the nuances of surgical and nonsurgical interventions used to treat wounds make our podiatrists uniquely qualified to treat challenging wounds.

 

UFAI is at the forefront of treating complex wounds and diabetic ulcers 

UFAI has expertise in far more than you will find at your routine medical center. Many wounds are not healing due to pressure distribution issues. Our podiatrists and foot and ankle surgeons specialize in the analysis and wound management treatments.

 

Obtaining the correct diagnosis goes beyond taking a medical history and performing an examination. Other diagnostic tests we can perform in-house at UFAI include:

  • non-invasive vascular studies (to look for blood flow issues)
  • wound biopsy or culture
  • X-rays, MRI, and CT scanning
  • blood work

 

Our goals at UFAI are simple: salvage all of the foot and ankle in a timely and cost-effective manner. Avoiding amputation, if possible, is a priority of diabetic foot care, as is protecting the foot from ulceration.

 

We strive to keep our patients on their feet for years to come. This may seem simple, but it is far more complicated than most patients realize.

 

University Foot and Ankle Institute, Southern California’s largest foot and ankle wound care specialists

UFAI is nationally recognized for advanced wound care treatment far beyond what a primary care physician can provide. Our doctors have decades of combined experience managing the special circumstances surrounding all types of foot and ankle wound care.

 

As one of Los Angeles’ largest podiatric healthcare practices, our wound care center offers multi-disciplinary medical care and diagnostic testing on-site, offering our patients convenience and peace of mind. For example, we can perform vascular testing at our clinics and have a vascular surgeon on our staff to treat patients with complex vascular diseases.

 

We are conveniently located throughout Southern California, and the Los Angeles area as our foot doctors are available at locations in or near: Santa Monica, Beverly Hills, West Los Angeles, Manhattan Beach, Northridge, Downtown Los Angeles, Westlake Village, Granada Hills, and Valencia, California. We accept over 1000 PPO health insurance plans, including Medicare.

 

If you want to learn more about how UFAI can help you, we encourage you to schedule a consultation with one of our foot and ankle specialists by calling (877) 736-6001 or making an appointment online.

 

Learn more about foot and ankle wounds

  • If left untreated, foot ulcers can lead to severe infections, serious complications and even amputation.

  • Proper treatment within the first several hours is particularly important and can greatly reduce the chance of complications.

  • While an infected surgical wound may be superficial and only involve the skin, left untreated, the infection can spread. Learn how to avoid serious complications.

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