Lower Extremity Wound Healing Center


Ulcers, which are open sores in the skin, occur when the outer layers of the skin are injured and the deeper tissues become exposed. They can be caused by excess pressure due to ill-fitting shoes, long periods in bed or after an injury that breaks the skin. Ulcers are commonly seen in patients living with diabetes, neuropathy or vascular disease. Open wounds can put patients at increased risk of developing infection in the skin and bone.

The signs and symptoms of ulcers may include drainage, odor or red, inflamed, thickened tissue. Pain may or may not be present.

Diagnosis may include x-rays to evaluate possible bone involvement. Other advanced imaging studies may also be ordered to evaluate for vascular disease, which may affect a patient’s ability to heal the wound.

Ulcers are treated by removing the unhealthy tissue and performing local wound care to assist in healing. Special shoes or padding may be used to remove excess pressure on the area. If infection is present, antibiotics will be necessary. In severe cases that involve extensive infection or are slow to heal, surgery or other advanced wound care treatments may be necessary.

Our Wound Care Process

How We Treat Wounds

  • Finding the Root Cause
  • Determining How Far the Condition has Progressed
  • State of the Art Wound Care Products

 Conditions Causing Wounds

  • Arterial Ulcers
  • Venous Ulcers
  • Diabetic Ulcers
  • Infection
  • Trauma
  • Burns
  • Swelling (Edema)
  • Pressure
  • Foot Deformities

Skin grafting is a serious wound care treatment that should only be used in the most extreme conditions. This procedure involves a patch of healthy skin being removed from one part of the body to be transplanted to another area that truly needs it. This method is used when an injury has resulted in deep tissue damage where surgical debridement is the only option to remove excess damaged skin. The following types of wounds are prime examples of when skin grafting can be an option:

  • Severe burns
  • Skin loss due to wound infection
  • Removal of skin cancer
  • Extensive trauma
  • Ulcers that don’t heal

Skin grafting is an extremely complicated procedure that may require stripping the dermis and epidermis apart while using a skin mesh to help bond the skin together. Additionally, it may require the full-on removal of the entire thickness of the dermis, which often means tissue removal from the chest, abdominal wall or back. Due to the complexity of the surgery, skin grafting is commonly associated with a number of risks, which may include:

  • internal bleeding.
  • wound infection.
  • reduced skin sensation.
  • uneven skin surface.
  • severe scarring.

However, there are a few alternative practices to consider for relieving the chronic wound healing stages.

Bioengineered skin

This is a type of tissue-engineered skin substitute that is created by using a combination of the outer epidermal layer with an acellular matrix material to produce a biological skin substitute to cover an extensive wound. This artificial tissue can work to temporarily take over the essential functions of the removed epidermis while new skin cells slowly grow back. The procedure is mainly used to treat various types of ulcers and generally produces less pain and serious complications than skin grafting can generate.

Negative-pressure wound therapy

This type of treatment helps further healing with acute and chronic wounds, as well as severe first- and second-degree burn marks. Using a specially designed sealed dressing, a vacuum is placed over the covering and ejects fluid from the wound which in turn helps stimulate blood flow to the injured area. After blood circulation gets back on track and cell migration is once again active, using open-cell foam dressings and gauze tape to cover the wound will help the skin healing process progress without having to surgically remove a healthier part of your body.

Skin cell gun

While this device sounds like something out of a science fiction movie, a skin cell gun is one of the latest wound healingtechniques considered as an alternative to skin grafting. The device extracts adult stem cells from healthier regions of the body and applies them to the wound using a computer program that helps evenly distribute the cells throughout the injury site. The gun has been under development since 2008, and is not widely considered as a frequently used alternative to skin grafting, the device is slowly picking up momentum after extensive research on the device was analyzed at the University of Pittsburgh’s McGowan Institute for Regenerative Medicine.

Upon your first visit, we will conduct a thorough examination of your lower extremity, including in-office digital X-rays and diagnostic vascular studies.

We’ll also examine the kind of shoes you wear and discuss your lifestyle and level of activity, which helps us rule out any other potential conditions.

Treatment Options

  • Debridement – State of the art debridement technology including enzymatic and mechanical debridement with PAIN CONTROL .
  • Offloading –  We use a variety of offloading devices from walking boots to total contact casts.  A key factor in healing your wound is NEW offloading techniques.
  • Arterial & Venous Studies – From the comfort of our Wound Healing Center, patients can receive NON-INVASIVE diagnostic vascular studies to help treat your wounds.  In the event that an arterial issue is diagnosed, our specialists have vascular surgeons standing by for consultation.
  • Shoe Changes – You might be surprised how many painful wound conditions are caused by your shoes. We’ll discuss the type of shoes you frequently wear to determine if they may be contributing to your open wound. We can recommend shoe stores where the staff is trained to properly fit shoes, plus we also have a wide selection of comfortable shoes available.
  • Pain Management– Some conditions like ulceration require adequate pain management to lead to wound closure and patient adherence to treatment plans.
  • Surgery – At the Achilles Foot & Ankle Lower Extremity Wound Healing Center, we only use surgery as a last resort after all other options have been exhausted. We will never recommend surgery right away, but will instead look for non-invasive alternatives first.  Dr. Baldwin specializes in these types of surgeries and ‘your feet are in good hands.’