Larry Lavery, D.P.M. Answers Questions On: Wound Care

At UT Southwestern, we’d like to be the kind of care organization that can heal your wound and keep it healed. Our team includes specialists in podiatry, plastic surgery, physical medicine, and vascular surgery, all focused on diagnosing and treating chronic wounds.

We have wound and ostomy care nurses on our team. We also have really good prosthetists and orthotists, the people who make braces and prosthetic limbs. Additionally, our facility has an aggressive referral process to the diabetes educators and dieticians. The wound care team’s goal is to provide comprehensive support for our patients.

Many of the basics you may be familiar with are true. It’s important to clean a wound with soap and water and keep it dry. At the very base level, patients should do what’s practical and allow common sense to rule the day. Unfortunately, we see a lot of patients who do things that really don’t make sense, like going Christmas shopping with sores on the bottom of their feet.

We are focused on wounds that take longer than 30 days to heal. Many of the patients we see are high-risk cases – individuals with diabetes, autoimmune illnesses, and other diseases that interfere with healing, and patients who have developed a wound after chemotherapy. They need to be aggressive about seeing a physician sooner rather than later.

What I found interesting was that the incidence of amputations in Mexican Americans is 150 percent higher – and 200 percent higher in African Americans – than in Caucasians. In each of those groups, men are twice as likely to have an amputation due to diabetic complications as women.

There are often treatments to prevent this from occurring. Our goal is not only to identify this has been a pattern, but to provide the appropriate education, intervention, and complex wound care to prevent amputations.

I think it’s because we (men) have to wait for something catastrophic to happen before we go to the doctor. And then we probably don’t listen when we do go. There are a lot of silent risk factors, like high blood pressure, that go unwatched and unnoticed. It’s important to practice self-care, and if diabetes runs in your family, to get checked out.

What’s also interesting is that for dialysis patients, the incidence of amputation is 10 times higher than in the general diabetic population. However, there were no differences among the races in dialysis patients.

Nutrition and exercise are obviously important for overall health. The average person probably does need to exercise more, particularly those with diabetes, since it is an obesity-related disease. However, patients with weight-bearing wounds should stay off their feet until their wounds heal.