Foot and Ankle Injuries: When Time Doesn’t Heal All Wounds

The phrase “time heals all wounds” is a nice sentiment, but it’s not necessarily true when it comes to wounds of the foot and ankle. This past August, I had three cases of non-healing wounds—all of them elderly patients with varying medical histories. In researching and treating them, I discovered a relatively new medical technology that delivers incredible results.

Niccoli healthy feet Bay Area podiatrist

A stubborn ankle ulceration

The first patient had a venous stasis ulceration along the outside of the ankle. The wound resisted the standard treatments of antibiotics, compression dressings, and daily dressing changes. After a month to six weeks with no change, we switched to more aggressive treatments, including activated collagen and silver sulfadiazine.

Following the switch, we did see some progress. However, the healing stalled at around 50% during the next month, and further treatments were ineffective.

At this point, we decided to take things a step further. We used an advanced technology known as Apligraf—a unique and fascinating product that contains proteins, collagens, and living cells. In technical terms, it’s cultured neonatal human tissue on a collagen matrix, which gives the wound plenty of growth factors and potential.

The results were amazing. Improvement was noticeable after one week of treatment, and what had been a chronic wound that lingered for five months was completely healed in a month.

Post foot surgery ulceration success

Soon after, we saw a patient in his 90s with a very large wound on the dorsal aspect of his foot, which had been present and non-healing for about four months. We began treatment with Apligraf right away. Not only did the wound heal with this treatment and incorporate with his normal skin, but there was no scar whatsoever left behind.

Apligraf treats a non-diabetic ulceration

Finally, we saw an 85-year-old non-diabetic man who was experiencing profound numbness. He developed a large ulceration on the tip of his toe, and had no idea the wound was there because he couldn’t feel it. While this type of wound is typical for diabetes sufferers, this particular patient was not diabetic.

In his case, we began the same standard wound care treatments applied to the venous stasis ulceration patient—compression bandages and antibiotics, followed by activated collagen and silver sulfadiazine. When the wound failed to progress into healing, we turned to Apligraf once again. The wound healed in two weeks.

Improved wound care with biologic technology

 We feel that Apligraf is a wonderful addition to the field of wound care, and has promising applications for healing foot and ankle injuries. In fact, we recently referred a patient to the Kate Creedon Center, a top wound care center in the area—and when the results were underwhelming, we brought the patient back to apply our more rigorous protocol, and achieved successful healing.

When you or a loved one is experiencing a prolonged foot or ankle ulceration, call Dr. Niccoli. We offer advanced wound care protocols and specialized wound care to deliver successful healing and relief.

Click here or Call us now at 510-521-3410  ~ Dr. Jeffrey J Niccoli  Board-Certified, Alameda Family Podiatry Group. Serving  patients throughout the Bay Area from San Francisco, Oakland, Fremont, and Alameda

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