What to expect at your first wound care visit

Call 908-215-5953 or book online through Zocdoc. When you call, tell us that you have a wound, how long it has been open, and whether you have diabetes, so we can see you soon. Let us know if another physician referred you. Some insurance plans require a referral for specialist visits; your carrier can confirm what your plan needs.

Please bring:

• Photo ID and your insurance card
• A list of every medicine you take, including diabetes medicines and blood thinners, and any allergies
• The names of your other doctors, such as your primary care physician, endocrinologist, or vascular or kidney specialist
• Recent records: X-ray or MRI reports, circulation test results, culture results, hospital discharge summaries and operative reports
• The shoes you wear most often, and any boot, brace, inserts or dressing supplies you’re using now
• A few notes: when the wound started, what has been tried, and any fever, swelling or change in drainage

Wear loose trousers or shorts, so that your feet and lower legs can be examined easily.

Most of the first visit is spent listening, examining and measuring.

• Your history and medicines: how the wound started and what has been tried, your diabetes, kidney, heart and circulation history, smoking, and every medicine you take.
• Your shoes: how they fit and wear, because a shoe is often where the pressure that opened the wound comes from.
• A circulation check: the pulses in your feet, with noninvasive circulation testing at our practice when it’s needed, to see whether blood flow is enough for the wound to heal.
• Measurements and photos: the wound’s length, width and depth, and a photograph, so that every later visit can be compared with this one. We also check sensation, foot shape and any signs of infection.

Read more in how a foot wound is evaluated.

• X-rays on site: X-rays are available at our practice and can usually be taken at the same visit. They help look for bone infection, a foreign body or a change in the shape of the foot.
• When more is needed: an MRI, arranged with an outside imaging center, to look for bone infection or a deep abscess; cultures from the wound tissue to choose the right antibiotic; and blood tests such as an A1c, coordinated with your other doctors.
• Circulation: if blood flow looks reduced, a vascular specialist arranges further imaging and treatment, and we coordinate the timing with your wound care. See circulation tests for foot wounds.

Most wounds are cleaned at the first visit. Debridement means trimming away callus, dead tissue and debris so the wound can heal from healthy tissue underneath. Many people with diabetic nerve damage feel little or nothing; if you do feel it, tell us before we start.

Then the wound is dressed, with a dressing chosen for its size, depth and drainage, and we explain how to care for it until your next visit and which changes should prompt a call. See wound debridement.

Pressure from standing and walking is the most common reason an ulcer on the sole of the foot won’t heal. For many of these ulcers, guidelines recommend a knee-high device that can’t be taken off. We fit it at the office and show you how to get around safely while you wear it. Other wounds may need a removable boot, a surgical shoe or padding.

See total contact casting and non-removable offloading and offloading boots and footwear.

Visits are usually every week or two while the wound heals. At each one we clean and trim the wound, measure it and adjust the plan. We see you sooner if there is any sign of infection.

A wound that is getting steadily smaller is on track. One that hasn’t improved after about four weeks of good care needs a fresh look: at blood flow, infection and pressure, and at whether a further treatment or an operation would help it close. See wound care visits.

Surgery is discussed when an infection needs draining, bone under the wound is infected, a deformity keeps reopening the wound, a Charcot foot is unstable, or a wound has stalled despite good care. An abscess or a deep, spreading infection can’t wait: the operation is usually urgent, sometimes the same day. If an operation is recommended, we talk through:

• what the operation involves, and why it is the right step for your foot
• realistic results, the risks, and the alternatives, including continuing wound care alone
• preparation, such as clearing infection, restoring blood flow, controlling blood sugar and stopping smoking
• where it will take place, a hospital or surgery center where Dr. Ozturk has privileges, and the type of anesthesia
• recovery: how long to keep weight off the foot, wound checks, and when you can return to shoes and walking

You are always welcome to take time to decide, or to seek a second opinion. See preparing for limb salvage surgery.

After surgery, or once a wound closes, recovery continues: keeping weight off the foot as instructed, regular wound checks, and a gradual return to shoes. A healed ulcer can come back, so we plan protective shoes, custom inserts and regular check-ups to keep your foot in remission.

If something feels wrong between visits, such as more redness or swelling, more drainage or a bad smell, calf pain, or pain that isn’t controlled, call the office the same day. For spreading redness with fever, black tissue, or a foot that is suddenly cold, pale or blue, call 911 or go to the nearest emergency department.

See recovery after limb salvage surgery and keeping a healed foot in remission.