Ulcers are open sores in the skin, occur when the outer layers of the skin are injured and the deeper tissues become exposed.
They can be caused by excess pressure due to ill-fitting shoes, long periods in bed or after an injury that breaks the skin. Open wounds can put patients at increased risk of developing infection in the skin and bone.
Vascular ulcerations can be related to blood flow coming into the foot and also blood flow leaving the foot. When a foot ulcer is related to a lack of circulation this is called an ischemic. The body requires Adequate oxygen to heal the ulcers wet in ischemic situations there is a lack of blood. This is seen with Smokers, diabetics, and patients have peripheral arterial disease. Treating these ulcers requires a multi- disciplinary plan. With being and the community for over a decade we have established relationships with vascular surgeons and Interventional cardiologists and patients can be seen within 3 days.
Patients also require adequate and appropriate dressing changes that can be done at home by 1 self or we can schedule home care. Offloading the ulcerations is also important and we are able to dispense in the clinic appropriate shoes, crutches, and knee scooters. At times the ulcer may be infected and we are able to prescribe the adequate antibiotics, take cultures or have patients be seen by infectious disease in a reasonable time frame. We are able to dispense wound care dressing and also will perform noninvasive treatments in the office setting or if needed formal surgery in the operating room at 3 different hospitals.
We have started to use a modality called ultramist that is assisting to increase oxygen to the wound temporarily and increase granulation tissue, with a simple not painful office visit. However at times with ischemic ulcerations wounds may be infected, gangrene, require amputation. We work with vascular or Interventional Cardiology to assess healing potential and amputate as little as possible to allow healing and patients to return back to their active daily living.
These ulcers are seen in many different Fashions. This can be seen with temperature burns; lacerations, open fractures, motor vehicle accidents, and gunshot wounds. These ulcerations are very difficult to treat, most will become infected, can be painful if the patient is not neuropathy, some require hospitalization and others require amputation.
In our office we are able to address most of the traumatic ulcers however if you are admitted into the hospital (Chelsea, Henry Ford Allegiance hospital, or Hickman hospital) ask your internist to consult us To address these injuries and obtain inpatient consultation by us. Once again the central treatments of an infection control, blood flow circulation, wound care and debridement, offloading and dressing, pain control, and appropriate follow-up are the central aspects to heal these wounds.
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For our patients’ convenience, we have our own digital x-ray, MRI, Cat-scan, and ultrasound equipment at many of our podiatry clinics. Our on-site podiatric physical therapy clinics allow for constant communication between the physicians and physical therapists, ensuring the most effective therapy and successful recovery for our patients.
Some of the case studies related to Ulcers are listed below. If you want to learn more about them click on the button below:
74-year-old female smoker with new onset of chronic ulcerations of her bunion and her 2nd toe. The patient has a history of peripheral arterial disease patient was seen and treated with ultra mist therapy twice a week for 4 weeks and also wound care daily dressing by the patient with collagen care we dispensed in the…
70 y/o female with venous stasis ulceration which failed home care. Initial Visit: 1 Week After Treatment: 1 Month After Treatment: 2 Month After Treatment:
60 y/o female with open infected venous stasis ulcerations Pre Compression: Post Compression: