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What is Management of Foot and Leg Wounds?

A wound is a break in the skin caused by an injury (cuts, scratches, and scrapes), surgery, or conditions such as diabetes. Management of foot and leg wounds refers to the care or treatment employed for the management of lower extremity wounds until they heal, addressing the immediate medical needs as well as precautions for the future. Some of the types of wounds include traumatic wounds, pressure ulcers, diabetic foot ulcers, as well as complex surgical wounds. Wound management is commonly indicated for wounds with drainage, pain, delayed healing, infection, and in cases where dressing changes are difficult, or compliance is poor.

Causes of Foot and Leg Wounds

Some of the common causes of foot and leg wounds include:

  • Diabetes
  • Cardiovascular conditions
  • Infections
  • Inflammatory disease
  • Peripheral neuropathy (nerve damage to the feet)
  • Muscle and bone abnormalities
  • Varicose veins
  • Poor blood circulation

Signs and Symptoms of Foot and Leg Wounds

Some of the common signs and symptoms of foot and leg wounds include:

  • Pain
  • Swelling
  • Tenderness
  • Redness and bruising
  • Bleeding
  • Burning and itching
  • Appearance of blisters, ingrown toenails, sores, or ulcers
  • Corns and calluses on the feet (thickened areas of skin that can become painful)

Diagnosis of Foot and Leg Wounds

Your doctor will diagnose based on your medical history, symptoms, physical examination, and the results of tests. The tests may include:

  • Wound culture to detect an infection
  • X-ray to detect bone infection
  • CT scan and MRI to evaluate infection in case your doctor suspects the presence of pus
  • Doppler or arteriography studies to assess blood flow to the feet
  • Blood glucose and glycohemoglobin tests to assess the levels of glucose in the blood
  • Complete blood count to determine white blood cell (WBC) count; high levels of which are indicative of infection

Management of Foot and Leg Wounds

Mild foot and leg wounds generally heal with resting and elevation, compression treatments, and antibiotic or antifungal treatment. However, treatment of chronic wounds may involve debridement or wound cleaning and wound dressing. Sometimes special therapies such as hyperbaric oxygen therapy, vacuum-assisted closure therapy, and therapeutic ultrasound may also be used to improve wound healing. Large wounds may sometimes require skin grafts from another part of the body, usually the thigh, to cover them.

Some of the treatment modalities involved in the management of foot and leg wounds include:

  • Medication: Your doctor may prescribe antibiotics to treat or prevent infection promoting faster healing.
  • Keep the wound clean and covered: The wound should be cleaned daily and covered with a bandage to reduce the risk of infection and promote healing.
  • Taking pressure off the wound: Depending on the severity of the lesion your doctor may recommend special shoes, braces, crutches, or a wheelchair to reduce pressure on the wound.
  • Surgical debridement: This process involves the removal of dead and infected tissue from the wound which reduces the risk of infection and enhances healing.
  • Hyperbaric Oxygen Therapy: This therapy involves inhaling concentrated oxygen while in a pressurized chamber for a period of time to promote the healing of tissues.
  • Correction of foot deformities: This involves surgical procedures to reduce pressure on the wound by correction of foot deformities and shaving bony prominences.
  • Amputation: In severe cases of wound infection such as gangrene, the affected part of the body is surgically removed to prevent the spread of infection to other parts of the body.

Prevention of Foot and Leg Wounds

Even after the wound heals, there is a chance that the wound may recur as the underlying problem still persists. Thus, the following precautions should be taken to prevent the recurrence of foot and leg wounds:

  • Compression bandages and stockings should be used at all times during the day. Legs should be kept elevated, whenever possible.
  • Moisturizing cream should be applied regularly, to prevent dryness and skin cracks.
  • Eating a nutritious diet and exercising regularly is important for general health.
  • If you are obese, talk to your doctor about healthy ways to lose weight.
  • Quit smoking as it delays healing.
  • Control blood glucose levels to within normal limits.
  • Wear comfortable and well-fitting shoes.

Legs and feet should be regularly examined for any minor skin condition such as blisters, broken skin, swelling, or redness and should be treated at the earliest, to prevent the development of a wound.

  • The Arthroscopy Association of North America
  • The American Osteopathic Academy of Orthopedics (AOAO)
  • The American Academy of Orthopaedic Surgeons
  • American Orthopaedic Foot & Ankle Society┬«
    Orthopaedic Foot & Ankle Foundation
  • American Academy of Osteopathy
  • American Osteopathic Association