Diabetic foot wounds and wounds from surgery or other trauma can be difficult to get to heal. Debridement of the wound combined with offloading are necessary to help wounds heal. Debridement involves removing the dead or fibrotic tissue and enzymes that building up on wounds and slow down healing. It seems strange, but we actually try to make the wound bleed when we debride it, because that stimulates the body to send new growth factors in to help heal the wound more quickly.
Offloading of wounds is especially important in diabetic foot wounds on the bottom of the foot. These often arise from pressure points, either from a normal prominent bone or from an abnormal prominence that can happen in condiations such as Charcot neuroarthropathy. Diabetes also causes the Achilles tendon to cross link and tighten and this leads to increase plantar pressures especially on the plantar forefoot. Offloading can either be done through casting or boot immobilization, or it can be done by surgically removing the bony prominence and/or lengthening the Achilles tendon.
There have been advances in the types of skin grafts that we can place on wounds to help them heal as well. We often now use grafts such as amniotic skin grafts that we can place on wounds to help them heal faster by bringing in stem cells and growth factors.
If you have a wound on your foot and ankle, don't delay treatment. The longer a wound remains open, the higher risk you are to develop an infection. We also know that the longer a diabetic foot wound takes to heal, the higher risk it is for needing a surgical intervention or amputation.
At Foot and Ankle Institute of Colorado, we remain open to treat you for all urgent issues. Our expert Colorado Springs podiatrists, Dr. Hinderland and Dr. Cameron, are up to date on all the latest techniques to help you with all your foot and ankle needs. Call us at 719-488-4664, if there is any way we can help you!
