Treatments
Wound treatment and limb salvage surgery
Good wound care is the foundation: clearing what stops healing, taking the pressure off, and treating infection and poor blood flow. When the foot needs more, surgery is often the step that closes the wound and keeps you walking.
Our approach
A stepwise path of care
Step 1: Check the wound and the blood flow
We measure the wound, check circulation with noninvasive testing at our practice and take X-rays on site, and bring in a vascular specialist when blood flow is low.
Step 2: Control infection
Antibiotics chosen from cultures, and prompt surgery to drain an infection and remove dead tissue or infected bone when antibiotics alone won’t clear it.
Step 3: Take the pressure off and clean the wound
Regular debridement at your visits, with a knee-high cast or walker or the right boot or shoe, so the wound is no longer pressed with every step.
Step 4: Close it: advanced therapies or surgery
For a wound that stalls despite good care: skin substitutes, a wound VAC or a skin graft, or surgery to correct the bone or deformity holding it open.
Step 5: Keep it closed
Protective shoes and custom inserts, regular check-ups and, when a pressure point keeps breaking down, surgery to correct it help keep a healed foot in remission.
Healing the wound
Where every plan begins
Debridement
Regularly trimming away callus, dead tissue and debris, usually in the office, so the wound can heal from a clean, healthy base.
Offloading
Taking the pressure off the wound so it can close. For many ulcers on the sole, that means a knee-high device that stays on day and night; we fit it at the office and show you how to move around safely in it.
Dressings and regular visits
A dressing matched to the wound, and visits usually every week or two to clean and measure it and adjust the plan, sooner if there is any sign of infection.
Treating infection
Antibiotics chosen from cultures of the wound tissue, and prompt surgery when an infection is deep, forms an abscess or reaches the bone.
Restoring blood flow
Noninvasive circulation testing at our practice and, when blood flow is too low for a wound to heal, referral to a vascular specialist for further imaging and treatment, timed with your wound care.
Advanced therapies, for the wounds that need them
Most wounds heal with the steps above. For a wound that stalls despite them, we use further treatments when they fit: skin substitutes and placental tissue grafts, negative-pressure wound therapy, and skin grafts or flaps. We refer you for hyperbaric oxygen when it may help.
Ulcers near the ankle from leg swelling
Compression and wound care to heal ulcers caused by leaky leg veins, after checking that the arteries can take it, with referral to a vein specialist when the veins themselves need treatment.
Blood sugar, nutrition and smoking
Healing depends on the whole body. We coordinate with your primary care physician or endocrinologist on blood sugar, and help you plan around smoking and nutrition.
Protecting the healed foot
Once a wound closes, therapeutic shoes, custom inserts and regular check-ups help keep it closed, and keep the foot in remission.
Limb salvage surgery
When surgery is the right step
- an infection has formed an abscess, is spreading or involves deep tissue, so it needs draining and the infected tissue removed, often urgently
- bone under the wound is infected, and removing that bone lets the wound heal
- a bent toe, a bony prominence or a tight calf keeps putting pressure on the same spot, so the ulcer keeps reopening
- a Charcot foot has collapsed or become unstable, and a brace can no longer protect the skin
- a clean wound has stalled despite good care, and closing it with a graft or flap, or reshaping the foot beneath it, gives it a better chance to heal
- part of the foot can no longer be saved, and a carefully planned partial foot amputation is the way to keep as much of the foot, and your walking, as possible
Treatment and surgery guides
Wound care visits take place at our offices in Lyndhurst, Paramus and Millburn, New Jersey (addresses and hours). Operations take place at the hospitals and surgery centers where Dr. Ozturk has privileges.
Limb salvage surgery
Treatment
Limb salvage surgery
Operations that clear infection, remove infected bone, take pressure off ulcers, rebuild collapsed feet and close wounds, with the aim of saving the foot and keeping you walking.
Treatment
Diabetic foot infection surgery
An operation that drains pus and removes dead and infected tissue from a diabetic foot infection, often in stages, before the wound is closed.
Treatment
Osteomyelitis surgery
An operation to remove infected bone in the foot, usually beneath a diabetic foot ulcer, so the wound can heal, often with a shorter course of antibiotics.
Treatment
Partial foot amputation
Surgery that removes only the part of the foot that can’t heal, from a single toe to the midfoot, keeping as much of the foot as is safe, to help you keep walking.
Treatment
Charcot reconstruction
Surgery that removes pressure points or realigns and fuses a foot or ankle collapsed by Charcot, aiming for a foot that can bear weight in a protective shoe or brace with less risk of ulcers.
Treatment
External fixation (frames)
A frame outside the leg, fixed to the bones with thin wires and pins, that holds a corrected Charcot foot steady or keeps weight off a healing wound.
Surgery that prevents ulcers
Treatment
Offloading surgery
Operations on the calf, Achilles or toe tendons (and sometimes a metatarsal bone) that take pressure off an ulcer so it heals and is less likely to come back.
Treatment
Exostectomy
Removing the bump of bone under an ulcer that won’t heal, from a collapsed Charcot arch to the ball of the foot: who it suits, results and recovery.
Healing the wound
Treatment
Wound care visits
What happens at a wound care visit, how often you’re seen, what you do at home, and when wound care steps up to surgery.
Treatment
Wound debridement
Removing callus and dead tissue from a foot wound, in the office or the operating room, so the wound can heal.
Treatment
Total contact casting
A knee-high cast or locked walker you can’t take off, which spreads pressure away from a foot ulcer so it can heal.
Treatment
Offloading boots and footwear
The removable boots, healing sandals, braces and therapeutic shoes that take pressure off a diabetic foot ulcer or a Charcot foot, how to wear them, and when surgery takes over.
Treatment
Wound VAC therapy
Gentle suction through a sealed foam dressing that can help a wound left open after foot surgery fill in and get ready to close.
Treatment
Skin substitutes
Thin sheets of bioengineered, donor or animal tissue, or placental membrane, placed on a stalled wound on top of good wound care to help it close.
Treatment
Skin grafts and flaps
Closing a clean, slow-healing foot wound with a thin layer of your own skin, or with nearby skin moved across it.
Treatment
Hyperbaric oxygen therapy
Breathing pure oxygen in a pressurized chamber as an add-on for diabetic foot ulcers that still aren’t healing after infection, pressure and blood flow have been treated.
Treatment
Restoring blood flow
Angioplasty, stents and bypass, performed by vascular specialists, restore blood flow to a foot wound that is starved of it; we test circulation, refer you and time foot surgery and wound care around the procedure.
Before and after surgery
Treatment
Preparing for surgery
How to get ready for limb salvage surgery: checking blood flow, working on blood sugar and medicines, quitting smoking, eating enough, planning around dialysis and setting up your home.
Treatment
Recovery after surgery
What the weeks after limb salvage surgery involve, from wound checks and keeping weight off the foot to preventing clots and falls, and how to keep a healed foot in remission.
Appointments
Talk with us about a wound that isn’t healing
A visit can show what is keeping the wound open and what will help it close: careful wound care first, and surgery when it is the step that saves the foot. See us within a day or two for any foot wound that isn’t healing, especially with diabetes.