If you have been receiving wound care for a foot wound, ulcer, surgical wound, pressure injury, or other skin breakdown, you may think of the problem as primarily a wound problem.
Sometimes it is.
But a wound is often the result of an underlying foot or ankle problem, and treating the wound alone may not address everything that needs attention.
A comprehensive podiatric evaluation looks at both the wound and the foot as a whole.
The wound is important—but it may not be the whole diagnosis
A podiatrist may evaluate:
- The location and depth of the wound
- Pressure and mechanical forces
- Foot deformity
- Walking patterns
- Shoes and footwear
- Circulation
- Neurologic status
- Infection
- Bone involvement
- Tendon and joint function
- Areas of abnormal pressure
- The patient’s overall foot and ankle condition
This broader assessment can help answer an important question:
Why did this wound develop, and what needs to change to keep it from coming back?
Off-loading is more than wound dressing
Many foot wounds are influenced by mechanical stress.
A wound may continue to recur if the underlying pressure is not addressed.
Depending on the situation, podiatric treatment may include:
- Off-loading
- Footwear modification
- Orthoses
- Bracing
- Immobilization
- Debridement when indicated
- Management of associated infection
- Treatment of deformity
- Pressure redistribution
- Surgical correction when appropriate
The objective is not simply to make the wound look better.
It is to create an environment in which the wound can heal and, when possible, reduce the factors that caused it.
Comprehensive podiatry also includes limb preservation
Some patients with diabetes, neuropathy, vascular disease, or previous ulceration require ongoing foot surveillance and preventive care.
A comprehensive podiatric evaluation can identify problems before they become wounds or determine whether a current wound requires additional intervention.
Depending on the patient’s circumstances, care may involve coordination with vascular specialists, infectious disease physicians, primary care clinicians, wound-care teams, orthotists, physical therapists, or surgeons.
Coordination does not mean that every part of the foot is automatically transferred to another specialty.
It means involving the appropriate professionals when their expertise is needed.
What if you are already seeing a wound-care specialist?
You do not necessarily need to choose between wound care and podiatry.
Wound care may be addressing the wound itself while podiatry evaluates the underlying foot and ankle mechanics, deformity, infection, bone and joint pathology, or need for surgical intervention.
In some cases, your podiatrist may recommend continuing with your existing wound-care team.
In others, additional podiatric treatment may be necessary.
What if your wound has healed?
That can be the ideal time to evaluate why it occurred.
A healed wound does not necessarily mean the underlying risk has disappeared.
Your podiatrist may evaluate:
- Recurrent pressure points
- Deformities
- Footwear
- Neuropathy
- Previous amputation
- Abnormal gait
- Areas vulnerable to future breakdown
Preventing the next wound is often just as important as treating the current one.
Comprehensive foot care means looking beyond the wound
A wound is located on a foot.
That foot is part of a mechanical and functional system.
Comprehensive podiatric care considers the wound, the foot, the patient’s function, and the factors that may have contributed to the problem.
At Seattle Foot and Ankle Center, Dr. Hoy begins with a comprehensive evaluation and determine what the patient needs. Wound care may be an important part of that plan, but we do not assume that the wound is the only problem requiring attention.
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