A common pathway to ulceration...the anatomy of a diabetic foot ulcer.

To the left, you see two pictures of the same foot.  This is a common presentation of the neuropathic diabetic foot. Neuropathic refers to the patient's inability to feel pain and the appropriate signals that would help a patient seek care sooner.  A patient has no sensation, they continue to develop callused skin in one area. After enough pressure from a callus develops a wound starts to form under the callus.  The patient could go for a very long period of time with the ulcer getting larger and possibly infected due to their lack of sensation that is often associated with long standing diabetes.

One of the most critical factors in a patient's successful outcome, is having a skilled physician involved in their care.  If you know someone or you yourself has a wound on the lower extremity, you need a doctor who has a passion for limb salvage.  Limb Salvage is a term that has been coined in reference to preserving the diabetic foot or a foot with an open wound.  Doctors who are trained in limb salvage have been specially trained.  As the diabetic limb salvage resident at West Penn Hospital in Pittsburgh, I spent two years diagnosing, treating and preserving limbs of many patients.  I can honestly say that no other part of what I do as a podiatrist is more gratifying than helping a patient prevent an amputation.  I have practiced in Clermont, Florida since 2002 and happy to say that I have helped save many limbs.  If a patient has a wound below the knee, I can help them!  My favorite place to treat wounds is at one of the two wound care centers that I see patients: Leesburg Regional and The Villages Regional wound care centers, but I also see people in Clermont in my office.

Dr. Henne and myself have had many conversations about our patient outcomes.  The most interesting part about our patients in our practice that are diabetic, is that they are not usually the patients that we have to perform amputations on or have to put them in the hospital for a debridement.  Debridement is a term used describe what a doctor does in order to remove dead or infected tissue from a wound. It could be superficial or down to bone depending on the severity and depth of the wound. What Dr. Henne and I take very seriously is the role we play in preventive care in the diabetic foot.  When we meet a patient who is diabetic for the first time in our office we explain the role we play in prevention of future foot problems, by means of At risk foot care. At risk foot care is the term used by insurance companies for visits to the podiatrist for care of the feet.  These visits are ways for early detection of foot problems that could lead to ulceration and possible infections. These visits are meant to put out fires before they start.  What we offer in our office is the patient is always seen by the doctor and only the doctor performs these services in our office.  There is no medical assistant trimming calluses in our office, only the doctor.  These visits do not seem like a huge deal to our at risk patients because they don't develop problems, just by keeping up with a good foot care regimen.

If you are diabetic you should be following some very simple rules:
1. Check your feet daily, and if you can not see or reach your feet, have someone else check them
2. Always wear protection on your feet
3. Avoid soaking your feet, unless otherwise instructed by your doctor
4. Do not wait to seek treatment for something suspicious on your feet

If you have an open wound or you have a loved one who has an open wound, and they have not had any improvement you need to think about seeking out a higher level of care. Look for a doctor who is passionate about limb salvage.  If you are in the Central Florida area, we would be more than happy to evaluate you.  Sometimes when patient's require more complex care, I see patients at the wound care center in Leesburg or The Villages. Call our office today if you would like an evaluation of your wound 352-242-2502.

Our office is located in Lost Lake Professional Village
Michele McGowan DPM
3190 Citrus Tower Blvd Ste A
Clermont,FL 34711.