WHAT IS A FOOT OR LEG ULCER?
An ulcer is an open lesion/wound that does not heal in less than two weeks. These now become chronic wounds that are prone to infection and form a layer of biofilm (bacteria that stick to each other and prevent healing) and bioburden (an excessive number of bacteria living on the surface of the wound). An excessive amount of bacteria prevents good tissue called granular tissue from developing and inhibits the healing of a wound.
WHY DO PEOPLE GET ULCERS?
Ulcers are caused by:
- Poor circulation (decrease in blood flow to the extremities)
- Venous insufficiency (the valves in the veins in the extremities fail to function and cause a pooling of blood and a slow down of flow)
- Peripheral neuropathy and nerve damage
- Lymphedema (fluid in the legs that remains stagnant and causes swelling)
- Smoking (whether past or present)
- Inflammatory diseases such as rheumatoid arthritis, lupus and gout
THE STEPS TAKEN AT CELLA FOOT & ANKLE SPECIALTY
An initial evaluation and medical history is performed in order to assess not only the wound but the patient as a whole. Each medical decision made is custom and tailored to a patient’s individual needs in order to determine the best course of action.
Tests may be performed such as X-rays (taken in the office), MRIs, or CT scans. If circulation is compromised, noninvasive studies are prescribed and at times patients are referred to vascular specialists. If an infection is present, a bacterial swab is taken and sent out to help with decision making on antibiotic treatment.
Depending on the type of wound and severity of the wound, there are several treatments available after careful debridement of the wound (removal of all dead and infected material);
- Prescriptions for custom pressured compression stockings
- Multi-layered compression wraps
- Unna boots
- Lymphedema pumps
Dressings / Graft Application Treatments:
- Moist to moist dressings
- Alginate dressings
- Debriding agents
- Antimicrobial dressings
- Bioengineered grafts
- Amniotic membrane grafts
- Total contact casting and boots
- Pneumatic walkers
- Deep toes or special shoes
- Custom orthotics with offloading devices
Constant Patient Care including 30-Day Wound Evaluations:
- We treat the entire patient not just the wound
- Patient’s home situation
- Smoking cessation
- Diabetic education
- Vascular tests & referrals as needed
- Nutrition assessment