Wound care and limb preservation

Your foot and ankle specialist may recommend evaluation when a wound isn't healing with basic care or circulation problems put tissue at risk. Assessment may be considered for: 

• Non-healing diabetic foot ulcers or infections despite standard wound care
• Peripheral artery disease causing rest pain, skin changes or tissue loss
• Venous ulcers with skin breakdown or swelling
• Post-surgical or traumatic wounds that show little improvement after four weeks
• Osteomyelitis or deep bone infection requiring more intensive treatment 

Your care team will review your health and guide you in choosing the best approach to support healing and protect limb function.

Nonsurgical

Care typically starts with nonsurgical approaches designed to stimulate healing and improve circulation. Your plan may include: 

• Specialized wound dressings and removal of damaged tissue to encourage clean healing
• Pressure relief with total contact casts, custom boots or padding
• Vacuum-assisted therapy to help draw out fluids and promote healing
• Vascular medications, compression therapy or hyperbaric oxygen
• Diabetes management, antibiotics and nutrition support 

Your care team monitors progress weekly with wound photos, cultures and vascular studies. Surgery is considered only if these approaches aren't enough. 

Surgical

If nonsurgical care can't restore tissue, our orthopedic foot and ankle surgeons use targeted procedures to remove infection, restore circulation and close wounds while preserving function. Procedures may include: 

• Removing infected or damaged tissue, including bone if needed
• Restoring blood flow through procedures like bypass surgery or angioplasty
• Covering deep wounds with skin grafts or tissue flaps
• Redistributing pressure or correcting deformities to reduce stress on your foot
• Performing procedures to help prevent amputation when necessary
• Using oxygen therapy in a pressurized chamber for high-risk cases 

Your surgeon will recommend the approach that best fits your circulation, the location of your wound and your rehabilitation goals. 

Many patients gradually resume modified daily activities as healing progresses. Your care team guides safe increases in standing, walking and exercise based on wound progress and overall health. 

Your personalized plan may progress like this, with timing adjusted to your needs: 

• Early phase: Keep weight off the wound, use specialized dressings, take antibiotics if needed and limit walking or standing.
• Later phase: Slowly increase weightbearing, use custom footwear or orthotics, apply compression therapy as appropriate and perform strength exercises.
• Longer term: Focus on balance and gait training, vascular or cardiac rehab if indicated and education to help prevent recurrence. 

Your care team monitors progress regularly and adjusts your plan as needed. After healing, recommendations often include diabetic shoes, routine foot checks, A1c monitoring and preventive exercises. 

Wound care and limb preservation treatment carries some considerations, as with any medical care. Nonsurgical therapies are generally low risk but require consistent follow-up to track healing progress. Surgical procedures may carry risks such as infection, delayed healing or the need for additional procedures depending on your circulation and overall health. 

Your care team will walk you through the risks and benefits relevant to your specific situation and answer any questions before moving forward with treatment.