Foot and ankle wound care: When a small problem can become something more complex

One of the most serious conditions I treat is a foot or ankle wound that won't heal. Many patients come to see me thinking it’s “just a sore” or “just a blister.” Sometimes that’s true, but I’ve also seen small wounds turn into serious infections when treatment was delayed.

The feet have less blood flow than other parts of the body, and that means healing can take longer. If you have diabetes, circulation problems, or nerve damage, the risk is even higher.

What’s a foot or ankle wound?

A wound is any break in the skin, including things like:

• Blisters
• Cuts
• Scrapes
• Surgical incisions
• Ulcers (open sores that don’t heal)

A foot ulcer is a deeper wound that doesn’t heal within a normal amount of time. I see these most often in patients with diabetes.

Why some wounds don’t heal and warning signs to watch out for  

In my experience, the most common reasons why wounds don’t heal include:

• Poor circulation
• Nerve damage (neuropathy)
• Ongoing pressure from standing or walking
• Infection
• Swelling in the lower legs

When blood flow is reduced, the body has a harder time fighting infection and building new tissue. If you notice any of the following, you should schedule an evaluation:  

• Redness spreading around the wound
• Warmth or swelling
• Drainage or odor
• Black or discolored tissue
• Fever
• A wound that hasn’t improved in one to two weeks

For patients with diabetes, I recommend calling as soon as you notice any change in your skin.

How I treat foot and ankle wounds

I take wound care seriously. My first step is to determine why the wound isn’t healing.

Treatment could include:

• Cleaning and removing unhealthy tissue (called debridement)
• Specialized wound dressings
• Offloading pressure with a boot or brace
• Infection treatment with medication
• Imaging to check for deeper infection
• Surgical care if necessary

Our team is made up of foot-and-ankle experts, and we treat everything from routine skin wounds to complex surgical needs. We also coordinate care with primary care providers and other specialists when needed.

In many cases, early treatment prevents hospitalization, which is why I always encourage patients not to wait.

Who’s most at risk?

I pay particularly close attention to patients who:

• Have diabetes
• Smoke
• Have poor circulation
• Have numbness in their feet
• Have a history of foot ulcers

If you fall into one of these groups, daily foot checks are important.

If you have a wound on your foot or ankle that isn’t healing, I encourage you to schedule an appointment. Early care can protect your health and prevent serious complications.