Chronic Wounds in Podiatry: Long-Term Management

Chronic wounds in podiatry can be severe if not treated on time. In certain cases, it may not even cause any symptoms earlier so you must do daily foot inspections for signs that indicate any foot problems. In case you go through trauma to your feet or have diabetes, follow proper foot, or wound care to prevent this problem. Learn all about long term management of chromic podiatric wounds in this article.



To diagnose chronic wounds, first, you must take a physical exam that focuses on the wound location, size, depth; the presence of drainage, and tissue type. Usually, most chronic wounds come under the category of etiology based on their location and appearance, which allows them to provide recommended treatment.

Different chronic wounds need different assessments for diagnosis:

  1. Arterial ulcer:

This is the most common type of chronic wound which is examined through different assessments such as arterial Doppler/duplex ultrasonography, segmental limb pressures, pulse volume recording, skin perfusion pressure, or transcutaneous oximetry. If the vascular test results show poor perfusion, then you should visit a specialist for treatment.

  1. Diabetic ulcer:

This type of chronic wound needs early intervention and management to prevent mortality after amputation. Its physical test includes ABI (ankle-brachial index) measurement, palpation of pedal pulses, and assessment for neuropathy with Semmes-Weinstein monofilament. To rule out deeper infections like osteomyelitis, doctors examine their noncompressible arteries to see if they have abnormally high ABI. For the more reliable tests, the doctor examines the toe-brachial index because it rarely calcifies.

  1. Venous ulcer:

This is one of the most common types of chronic wound which causes signs such as venous hypertension, including edema, hemosiderin staining, and lipodermatosclerosis. Its assessment includes the arterial status of the ankle-brachial index (ABI) and palpation of pulses to rule out mixed arterial and venous disease. If needed, they also do venous duplex ultrasonography with reflux to find what causes your chronic wound.

  1. Pressure ulcer:

To assess pressure ulcers doctors, examine for infection, imaging tests to rule out deeper infection, and use tools Braden scale to minimize pressure ulcers to identify high-risk patients. The main goal during pressure ulcer assessment is to find how much tissue has been damaged.

Sometimes while assessing a chronic wound for infection, physicians should not only check for chronic infected wounds but also acute infected wounds as well because both cause different signs and symptoms.



Usually, chronic wounds are treated by the TIME principle:

  • Tissue debridement (applied to all cases except arterial ulcers),
  • Infection Control,
  • Moisture balance, and
  • Edges of the wound.

After these measures, the ulcer is correctly diagnosed or classified for appropriate care.

Debridement is the method to remove dead cells which serves as an important part of wound care. This is the first-line treatment for chronic wounds. In addition to removing dead cells or tissue, biofilm is also removed with it to make it self-produce an extracellular matrix that can heal wounds.

To control the infection, topical agents are used. Antimicrobial washes may be beneficial if biofilm is suspected. In case of cellulitis or systemic infection, oral antibiotics are also used.

Moisture balance is an especially important part of wound care because it heals more quickly with less risk of infection. So, ensure your chronic wounds aren’t exposed to air to dry out. If your wound looks dry, add appropriate moisture to the dressing. If your wound is draining, the drainage must be controlled and kept off the wound. The proper dressing keeps the moisture on the wound bed to prevent desiccation.

Keep the wound edges free from undermining because if edges get rolled, then they should be excised. This allows the process of epithelialization, which is the clearest sign of wound healing.



The best way to prevent any type of leg wounds or injuries is to do daily foot inspections. Check your feet regularly for signs such as red spots, cuts, swelling, or blisters. Wear proper fitting footwear, eat a healthy diet, and maintain healthy glucose levels to keep your feet sore-free.


If you need help with foot wounds, visit our podiatry clinic in Brooklyn for professional help. If you experience any foot problem, visit our podiatry clinic in Brooklyn, where professionals examine your foot and treat it accordingly so that your foot gets better as soon as possible. For more tips on healthy feet, or if you need help with finding a good podiatrist, Doral Health & Wellness employs Podiatrists with extensive education and expertise. Trauma to the tendons, muscles, and bones of the foot is quite common. It’s not a good idea to put off seeing a Foot Doctor Brooklyn until you’re in a lot of pain. Our address is 1797 Pitkin Avenue, New York, NY 11212. To make an appointment, please call +1-347-384-5690 or send an email to