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What is wound debridement? Debridement is a procedure used to remove dead, damaged, or infected tissue from wounds. Wound debridement is designed for both acute and chronic wounds. Making sure to get the wound debrided helps to prevent infection. Several clinical studies recommend weekly wound debridement and they have higher rates of wound closure. Before the debridement, the office administers topical lidocaine and/or injectable lidocaine to numb the area and lessen the discomfort which can accompany the procedure.

Why does my wound have to be debrided?

  • Wounds can heal much faster when dead tissue is not present. Dead tissue frequently traps bacteria which can cause infections.

  • New tissue cannot grow when dead tissues are present. Hidden pockets of pus could lie under the dead tissue which can also cause an infection.

  • Infections prevent the wound from healing and can get worse. It can lead to an amputation or a life-threatening condition if it gets into the bloodstream.

  • Routinely removing dead tissue keeps it clean and will help the wound to grow new tissue.

How will the dead tissue be removed from my wound? There are a few ways to perform the debridement. The doctor may use one or more of them to

remove dead tissue:

  • Sharp debridement: This can be performed every week. It keeps the wound clean and helps it to heal quicker. The dead tissue is removed with a sharp instrument. A dressing is then applied. Occasionally, a sharp debridement will have to be performed in the operating room.

  • Autolytic debridement: This pain-free. A moist wound dressing is used in combination with body's ability to destroy dead tissue. This can be performed between visits. When it is used, the doctor may not have to perform a sharp debridement during the next appointment.

  • Enzymatic debridement: Occasionally called a chemical debridement, this is where medication is used to break down the dead tissues. It can be used in conjunction with a sharp debridement.

  • Mechanical debridement: Whirlpool, pulse lavage, or wet to dry saline dressings are employed. Healthy and new tissues can be affected however, so this is not used often anymore.


Skin Ulcers Q & A

What is a skin ulcer?

A skin ulcer is an open wound on the skin. It can be caused by infections, by a pressure sore, or by vein problems. Treatments will depend on the cause of the ulcer. Venous skin ulcers, the most common, are shallow wounds which occur when the leg veins don't return blood back toward the heart properly. These ulcers usually form on the lower leg, above the ankle, and beneath the calf.

What causes a skin ulcer?

Venous skin ulcers are caused by inadequate blood circulation, namely venous insufficiency. In venous insufficiency, the valves have been damaged and blood is now backing up and pooling inside the vein. Fluid can then leak out and into the surrounding tissues, resulting in the breakdown of the tissue and an ulcer. Factors that can increase a person’s risk for ulcers include:

  • Deep vein thrombosis

  • Obesity

  • Smoking

  • Lack of physical activity

  • Standing for many hours a day

What other types of skin ulcers are there?

Aside from venous skin ulcers, the others that can occur include:

  • Arterial skin ulcers occur when artery disease is present. These ulcers can be very painful. They are typically on the feet and toes.

  • Neuropathic skin ulcers are also referred to as diabetic neuropathic ulcers. They develop in those who have little or no feeling in the feet because of diabetic nerve damage.

How are they treated?

Initially, improving blood circulation can help. Patients can try:

  • Lifting the legs above the heart level frequently.

  • Wearing compression stockings or bandages to prevent blood from pooling in the legs.

  • Walking daily to improve blood circulation.

The doctor often performs a debridement to excise dead tissue from the wound. After the ulcer has healed, compression stockings should still be worn, taken off for bathing and sleeping. The doctor may advise additional treatments if needed such as:

  • Medication to hasten to heal or for an infection such as antibiotics.

  • Skin grafting, for deep or hard-to-heal ulcers.

  • Recommend vein surgery, which can keep ulcers from returning.

More questions or would like to make an appointment? Call 626-517-0022.


A Handy Checklist for Our Diabetic Patients


When you have diabetes, you need to examine your feet every day. Look at all areas of your feet, including your toes. Use a handheld mirror or a magnifying mirror attached to the bathroom wall near the baseboard to inspect your feet. If you have poor visit, have someone else use this checklist to examine your feet for you.

Using this checklist helps you remember to examine all areas of your feet for daily foot exams.

Check your feet for the following:


Skin color

  • Red, blue or black coloration

  • Redness could point to irritation from shoes or overheating or other early signs of a problem. Do what you can to discover the cause and fix it, such as wearing shoes that fit better.

  • Blue or black areas can mean bruising or blood flow problems. Call your doctor to report them.

Missing hair?

  • Patches where hair is missing? Bald patches may mean irritation from shoes or a blood flow problem. Show the areas to your doctor during your next visit.

Blister

  • Try to discover the cause of the blister. Friction or rubbing against your skin causes blisters. You may need new shoes.

  • Do not break the blister or open it yourself. Leave the skin over the blister intact.

  • Cover the blister with a sterile, nonstick dressing and paper tape.

  • Call your doctor if any blister becomes red, oozes, or is not healing after 4 days.

Breaks in your skin

  • Gently wash the area with mild soap; blot it dry and cover it with a sterile, nonstick dressing.

  • Call your doctor if any break in the skin becomes red, oozes, or is not healing after 4 days.

Note: Examine the underside of your toes and the area between the toes for breaks in the skin.


Calluses (hardened areas of skin) and corns (pressure injuries, usually found on or between toes).

Show the area to your doctor at your next visit. This is very important.

  • Do not use products sold in drugstores to remove corns, calluses, or other problems.

  • Do not use a pumice stone on calluses unless your doctor or foot doctor (podiatrist) shows you how to use it properly.

  • Do not cut, file, or do anything that may break the skin on your feet.

Peeling skin or tiny blisters between your toes or cracking and oozing of the skin. This may be athlete's foot. Treating athlete's foot early can prevent serious foot infections.

  • To prevent athlete's foot, wear shower shoes or bathing shoes when you use public showers or pools. Otherwise, keep feet dry.

  • Keep feet clean. Wear clean socks every day.

  • Do not treat athlete's foot without first seeing your doctor or podiatrist.

Moisture between your toes

  • Dry between your toes well. Moisture between your toes provides a good place for bacteria and fungi to grow, causing infection.

Feelings of numbness, burning, or "pins and needles"

  • If you have new numbness or tingling in your feet that does not go away after changing position, call your doctor.

Sore (ulcer)

  • Do not try to treat a foot ulcer at home. Call your doctor immediately. If you check your feet regularly, you usually will see a problem before it becomes an ulcer.

Ingrown toenail

  • Do not treat an ingrown toenail at home. Do not dig into the corners of your nails for relief! Call your doctor for an appointment. These can become painful and infected if they are neglected. You can also cause permanent nerve damage by foregoing professional treatment by a doctor. Do not allow any pedicurist to convince you otherwise!

Need more help?

Want more information?


Call (626) 517-0022 and let our office know you'd like to schedule a diabetic foot check! Your insurance will cover this service.






Why are our Orthotics better than a Prefab orthotic?


Orthotics is a very broad term. It can range from an off the shelf device that is built to fit an average foot with only minor problems to a custom pair created specifically for you. There are some prefab/over-the-counter orthotics that do work better than the rest. We can discuss these at your appointment- and we have them for sale at our office.


At Pasadena Orthopedics, each of our orthotics are made to fit the person's feet. We do this by scanning each foot using a digital scanner. It is not messy, highly accurate, and takes less than 5 minutes. The 3D scan is then sent to a laboratory for 3D printing. You will pick up your orthotics in 1-2 weeks.


Many insurances do cover one pair per year. However we also take cash payment if your plan does not cover this service.


If you have a severe lower extremity deformity, you may be better suited for an Ankle Foot Orthoses (AFO). This is also pictured below. Call 626-517-0022 for an appointment to be evaluated today!




Foot Massage

Treatment Methods

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