I have an Ulcer, How will it be treated?

The very first step in treating an ulcer is having a thorough history and physical exam by your podiatrist. It is necessary to determine what type of ulcer you have and what are the underlying diseases that are causing the problem. Once the type of ulcer has been determined treatment can begin. Often it is necessary to perform lab work X-rays, bone scans, MRIs and circulation tests in order to stage the severity of the ulcer. This testing very often helps to direct a treatment plan.

The cornerstone of treatment in most cases includes good local wound care and trying to address the fundamental cause. Your treatment may consist of:

1. 
   
   Consultation with other professional in vascular surgery, orthotics, endocrinology and primary care;


2. 
   
   Debridement or removal of devitalized tissue within and around the ulcer;


3. 
   
   Oral antibiotics or hospitalization for intravenous antibiotic when severe infection in present;


4. Rest, off-loading the foot to decrease pressure on the ulcer site. This could employ cast braces or splints; 4a. In case of a venous ulcer, compression or Una boot therapy might be used.


5. Use of growth factors directly on the wound;


6. Surgical intervention to remove abnormal or diseased bony prominences and skin grafting or use of skin substitutes to cover the area;


7. Once healing has occurred, the goal is prevention of re-ulceration. This could be achieved with custom molded shoes, braces, inserts.

Very often, treatment is a long, difficult, and sometimes a discouraging process. Realize that it most likely will constitute a team approach to manage the other prevailing medical problems you have that gave way to the development of the ulcer.

It is important for you to follow your podiatrist's directions in your ulcer treatment plan. You are the most important factor in resolving this problem. So be an active participant in your treatment, ask questions and be sure you understand what is being done.