Foot Wound Care

Updated 4/7/2021
Foot Wound Care, University Foot and Ankle Institute of Los Angeles

Worried about a non-healing wound on your foot?

Your skin is your body’s first line of defense. Wound care is far more than fixing a wound, it is a process of investigating the reasons why a wound is not healing.

 

From poor circulation, uneven pressure distribution on the foot, prominent bones to foot and ankle deformities, wound care is a technical process that requires expert analysis and treatment.

 

Lingering wounds and ulcers (often due to diabetes), circulation problems, foot deformity, or immobility,  can result in severe tissue damage or amputation if left untreated.

Not all foot wounds are the same

Did you know that diabetic foot ulcers can be a marker of a far more serious underlying medical condition? According to the American Diabetes Association, diabetic patients and those with uncontrolled blood sugars, the presence of foot ulcers is associated with peripheral arterial disease, heart attack, stroke, renal disease, nerve damage, and amputation. More than 60% of lower-limb amputations occur in diabetic patients and 85% of these amputations are preceded by a foot ulcer. 

 

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%.

 

That’s why it’s important to seek out a foot and ankle specialist who can determine the cause of the wound or ulceration and design an appropriate treatment plan to address it.

  

 

Why seek out a podiatrist to treat a foot wound?

Wound examination by a foot and ankle specialist at UFAI involves looking at the patient from 4 key vantage points: vascular (meaning your circulation), dermatologic (skin integrity), orthopedic (bones, muscles, and ligaments), and neurologic (nerves). Expertise in these key areas as well as in lower extremity biomechanics, structural deformities, and the nuances of both surgical and nonsurgical interventions used to treat wounds makes our podiatrists uniquely qualified to treat challenging wounds.

 

Obtaining the correct diagnosis goes beyond taking an extensive medical history and performing a thorough examination. It may require tests that can include non-invasive vascular studies to look for blood flow issues, a wound biopsy or culture, x-rays, MRI, CT scanning, and perhaps blood work, all of which can be performed at UFAI.

 

Once all the evidence is collected and the problem is diagnosed, a foot wound treatment program is developed to fit your unique situation. Our doctors often coordinate with other healthcare providers (such as your primary care doctor or endocrinologist) to make sure that you receive the best possible care.

 

Our goals at UFAI are simple. Attempt to salvage all of the foot and ankle in a timely and cost-effective manner. Avoid amputation at all expense, if possible, and get the patient back to their life in a pain-free and rapid manner. Protect the foot from further ulceration and keep our patients on their feet for years to come. This may seem simple, but it is far more complicated than expected and requires a comprehensive approach from an expert team. 

 

 

What types of foot and ankle wounds do podiatrists treat?

Podiatric wound care specialists can treat lower extremity wounds related to:

 

  • Complications of diabetes
  • Complications of neuropathy
  • Complications of poor circulation (venous or arterial vascular disease)
  • Complications of surgical wounds
  • Skin infections
  • Foot puncture wounds, pressure ulcers, or injuries with a breakdown of the skin
  • Wounds resulting from prolonged immobility or bed rest
  • Wounds from prolonged use of ill-fitting shoes

 

 

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

UFAI physicians, nurses, and technicians have extensive experience in the latest technologies used for healing a wide variety of chronic non-healing wounds, not just for wound care of diabetic foot ulcers

 

This includes regenerative medicine treatments that stimulate your body to heal itself. These modalities include:

 

SoftWave Tissue Regeneration Technology

UFAI is one of a few select medical practices in Southern California that offers this FDA-approved acoustic wave technology to speed up your body’s natural ability to heal soft tissue and bone injuries providing fast pain relief and restoration of mobility. Best of all, it does so without needles, steroid injections, anesthesia, or the need for hospitalization.

 

SoftWave therapy involves delivering consecutive focused sound waves that send high-energy impulses to painful or injured tissues, triggering their native healing response. The treatments are performed during an office visit and are virtually painless, involve no downtime, and have no side effects. This technology is used in orthopedics, sports medicine, and even urology practices with great results.

 

Amniotic membrane tissue grafts

Another exciting regenerative treatment modality delivering excellent outcomes for chronic wounds that have failed to respond to other treatments is the use of human amniotic membrane tissue grafts to stimulate the healing process.

 

Interestingly, the human amniotic membrane has been used in wound care for nearly a century. That’s because the amniotic membrane has several unique characteristics that make it uniquely qualified to increase and enhance the wound healing process. For instance:

 

    • It provides a matrix in which cells necessary for tissue healing can grow
    • It contains biologically active stem cells that regenerate new cellular material important for growth and healing
    • It has non-immunogenic properties (meaning your body can’t recognize it as a foreign substance and so won’t target an immune response to reject the graft unlike some other skin substitutes)
    • It has anti-bacterial properties
    • It reduces inflammation and scar tissue formation
    • It reduces pain at the wound bed

 

High-Pressure Wound Vacuums

Wound vacuums, or VAC systems as they are often called, are an essential part of wound healing in complex limb salvage and ulcer care cases. A wound VAC (also called negative pressure wound therapy) is a pressurized suction system that literally sucks on a wound and pressures the body to fill the void. This outpatient at-home treatment is very specialized care that allows us to heal deep and complex wounds. 

 

Once there is a good healing base to the wound, the VAC system may be combined with amniotic grafts, skin grafts, flap closure, or surgical remodeling to initiate the final steps of closure. VAC therapy is not for everyone and not all doctors know how to properly use this treatment. UFAI is an expert at VAC use and we have used this treatment to heal many complex and otherwise untreatable wounds at our institutes.

 

Flap closures and complex skin grafting techniques

Complex Wound Closures are our specialty, and these can be very difficult to close. A wound that will not heal with simpler wound care protocols or amniotic grafts demands more advanced treatments.

 

 Our doctors specialize in flap closures of wounds and complex skin grafting techniques. From muscle flaps to complex wound flaps utilizing the person’s own tissue to fill ulcer voids to complex skin graft techniques, we offer comprehensive wound healing options that make us a national referral center for wound repair and limb salvage.

 

Advanced surgical care

Though not common, there are times that surgical care may be necessary for the form of bone realignment and deformity correction. Our surgeons are experts at deformity correction associated with wound care and ulcer repair. Surgeries are often performed in an outpatient setting with the patient returning home the same day and with little need for anesthesia risk. No deformity of the problem is too big for us to handle which allows us to treat many complicated issues other doctors will shy away from.

 

 

It’s the Essentials that Make Us Different

UFAI has expertise in far more than you will find at your routine diabetic wound care medical center. Many wounds are not healing due to pressure distribution issues. Our podiatrist and foot and ankle surgeons specialize in the analysis and treatment of foot and ankle deformities that increase pressure on the ulcer or wound site causing the wound not to heal.

 

The process begins with x-rays of the foot and ankle and pressure analysis. If there is excess pressure on a region, (from conditions ranging from calluses and toenails to osteomyelitis, a bunion, hammertoe, and other foot problems), our advanced MRI and CT scanning can find the reason for the blisters and ulcerations and we are experts at treating such issues.

 

Simple pressure distribution correction might be with an orthotic or custom insole to protect the high-pressure region and provide pressure stabilization by spreading the high pressure to areas taking less pressure which reduces stress and helps with wound healing.

 

 

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

UFAI is nationally recognized for the treatment of diabetic foot ulcers and our doctors have decades of combined experience in managing the special circumstances surrounding diabetic foot care. In addition, our board-certified foot and ankle surgeons are internationally recognized experts in the field of regenerative medicine to treat foot and ankle conditions.

 

If you are concerned about an open sore on your lower leg or foot that’s taking longer than usual to heal, you may benefit from advanced wound care by one of the foot wound experts at the University Foot and Ankle Institute (UFAI) wound care centers

 

As one of Los Angeles’ largest podiatry practices, UFAI is able to offer multi-disciplinary medical care and diagnostic testing on-site, offering our patients convenience and peace of mind. For example, we are able to perform vascular testing at our clinics and have a vascular surgeon on our staff to treat patients with complex vascular disease.

 

UFAI doctors have had great success in healing wounds that were considered untreatable in the past. That’s because we utilize leading-edge technology such as gentle shock wave 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.

 

At UFAI we take pride in our holistic approach to wound management, offering both medical and surgical treatment options for foot and ankle conditions. It’s this kind of dedication and experience that earns us the trust of our patients every day.

 

If you would like to learn more about how the Doctors of Podiatric Medicine (DPM) at 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 make an appointment online now.

 

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.

 

At UFAI, we take our patients’ safety seriously. Our clinics’ and surgery centers’ Covid-19 patient safety procedures exceed all CDC recommendations. Masks are required in our institutes at all times.

  • Foot and Ankle Surgeon and Director of University Foot and Ankle Institute
    Dr Bob Baravarian, University Foot and Ankle Institute

    Dr. Bob Baravaria DPM, FACFAS is a Board-Certified Podiatric Foot and Ankle Specialist. He is currently a member of UCLA Medical Group, Chief of Podiatric Surgery at Santa Monica/UCLA medical center and Orthopedic Hospital, and an assistant clinical professor at the UCLA School of Medicine. He also serves as Director of University Foot and Ankle Institute.

     

    Dr. Baravarian has been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy, and trauma/reconstructive surgery of the foot and ankle. He is also fluent in five languages (English, French, Spanish, Farsi, and Hebrew),

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