Types of Wounds
Podiatry deals with many different kinds of wound. There are traumatic wounds caused by physical objects or fractured bones. Some lower extremity wounds are caused by surgeries that are performed to correct other problems. Venous stasis ulcer are sores on the legs caused by swelling of the legs. However, the majority of the wounds to the foot and lower extremity are pressure related and seen in diabetics and patients with poor circulation.
Ulcerations are sores to the body that break through the outer lining (ie stomach ulcer breaks through the lining of the stomach). The foot refers to breaking through the layers of skin. Diabetics get ulcers because they cannot feel their feet (neuropathy). A pressure area keeps breaking down the skin and the patient does not change their activity to alter the pressure.
Ulcers can be caused by poor circulation. This usually occurs at the toes since the circulation is poorest at the end of the foot. The skin just dies from lack of bloodflow.
Wound care is the most evolving phase of podiartic care. More modalities and procedures are being developed every day. Certain basics are relevant to all the different treatments. First is address the underlying problem. If the wound is caused by poor circulation, a bypass, angioplasty, or medication is necessary to close the wound. If the wound is caused by pressure, then the pressure must be eliminated by shoes, casting, crutches, surgery, etc...
Infection will also prevent a wound from closing. The infection must first be diagnosed by x-ray, bone scan, CT scan or MRI. The proper antibiotic is used based on a culture of the wound. In some cases, surgical procedures are used to irradicate bone and soft tissue infections.
Lastly, the wound must be properly treated. This is the most debated topic in medicine. There are many proper wound care techniques and none works on every patient. Antibiotic creams, wound cleansers, growth factors, special covers, etc.. are all used in certain wounds. The newest techniques is artificial skin grafting material that can speed up the the closure dramatically.