Why Does Your Podiatrist Make Your Wound Bigger To Heal It?

For those of you who have had wounds develop on your feet, it may have come as a bit of a surprise when your podiatrist removed a wide path of what you though was good skin along the edge of the wound.  I have numerous patients myself who have this reaction, and will complain that I am making the wound worse (presumably as a conspiracy to keep billing for the procedure).  Well, I hate to disappoint, but the real reason we do this is to actually heal the wound quicker (which saves you time and money/insurance dollars spent).  You see, the majority of what most people think is healthy tissue around the wound edge on the wound surface is in actuality not healthy, and needs to be removed to optimize the wound environment.

Tissue that is soft and mushy, callused, scabby, yellow and loose, or otherwise not either normal skin or bright red tissue needs to be removed.  Sometimes this means that only a small amount of tissue has to be removed, and sometimes a wide ring around the central wound has to be removed.  If the tissue does not bleed, it is not part of a healthy wound surface and the tissue removal process needs to continue to bleeding tissue is reached.  Think of a wound as a crater.  Wounds heel by first filling the crater up with a beefy red tissue called granulation tissue.  Once this is close enough to the height of the surrounding skin, the skin will then 'creep' over this tissue from the outside to the center.  In order to do this, the granulation tissue needs to be healthy and the surrounding edges of the 'crater' need to be free of unhealthy tissue.  Wound care (debridement) keeps these tissues healthy.

There are some exceptions to this rule, such as wounds due to severe circulation disease that sit over bone.  In these cases a more gradual and chemical approach is made to remove the abnormal tissue rather than sharply cutting it out.  However, for most wounds, unhealthy tissue removal is necessary, as diabetic wounds do not heal like childhood skinned knees.  Wound care intervention and callus care to prevent wound formation, even if bleeding is created, neither causes nor prolongs wounds.  They simply create a healthy environment to foster healthy skin growth over the wound surface.

Until next time,
Scott R. Kilberg DPM

www.inpodiatrygroup.com - foot surgeon, podiatrist in Indianapolis
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A foot doctor in Indianapolis Noblesville Fishers Carmel Westfield and Fortville Indiana.