There are several reasons why a foot or ankle wound does not heal in a timely manner:
- Pressure on the area
- Local soft tissue infection (cellulitis)
- Underlying bone infection (osteomyelitis)
- Poor circulation
- Poor nutrition
- Decreased immunity
- Presence of callus
- Skin cancer
When a foot or ankle wound is not healing, the individual must be assessed by a foot and ankle physician. After obtaining the medical history of the patient and the wound, the doctor will examine the wound. Debridement, or removal of non-viable tissue, may or may not be indicated. Tests such as blood work, arterial Doppler, x-rays, bone scan, CT scans, and/or MRI may be ordered. Depending on the age and appearance of the wound, a biopsy may also be necessary.
Once the causative factors are identified, a plan of action is devised. This may include oral and/or intravenous antibiotics, consultation with an internal medicine doctor, vascular specialist, an infectious disease doctor, and/or a registered dietician. Sometimes an infection can be limb- or life-threatening, and may require immediate hospitalization. The individual may also need surgery, specialized wound care products and off-loading devices. If skin cancer is identified, a musculoskeletal oncologist will be consulted.
