Our Philosophy regarding diabetic wound care is to solve the underlying problem.
We have seen patients who have had wounds healed, only to break down soon afterwards, because the underlying problem was not addressed. We have many patients that have undergone extensive periods of wound care with unsatisfactory results, and out of desperation they contact us for help. In many of these cases, we are able to resolve the underlying problem and heal the foot ulcers. The reason for our success in these cases is because our approach to the wound is different. We do not approach the wound as a "skin problem". Generally, there is nothing wrong with the patients' skin. The skin on other parts of the foot is fine, but something is causing the area to ulcerate. That "something" is usually pressure caused by bony abnormalities, muscle imbalance, or underlying deformity, and until the pressure is alleviated, the wound is at risk for recurrence. Once the underlying cause of the wound is alleviated, the skin is usually able to heal.
Once we determine what is causing the ulcer, we employ a full gamut of therapies to offload foot wounds, apply correct advanced wound care products, and offer patients appropriate assistive devices to help the patient with a diabetic wound to achieve a successful outcome of wound closure as quickly as possible. We also participate in the Medicare Diabetic Shoe Program.
In cases where these conservative methods to not adequately offer relief, surgery is considered. Surgical correction of pressure points offers the diabetic patient a chance to increase their likelihood of healing current foot ulcers, and significantly lower their risk of future foot ulcers, and lessen the risk of amputation. Contrary to popular belief, diabetics CAN undergo foot surgery, provided certain parameters are met. We perform in-office testing for patients' vascular and neurologic status, and we work closely with vascular surgeons, as needed. If a patients' vascular status is adequate, and their sugar is well-controlled, clinical studies have demonstrated that the risk of performing surgery on a diabetic is not significantly different than that of the general population.
If you have a stubborn diabetic foot ulcer, please call and arrange for an evaluation by Dr. Silveste