A wound that has not closed in six weeks is not healing for a reason — pressure, poor blood supply, infection, uncontrolled blood sugar or all four. Treatment removes the reason and then stimulates healing, where appropriate with PRP applied to the wound. This is team care with your diabetologist and, where needed, a vascular surgeon.
Healing needs blood supply, protection from pressure, freedom from infection and good glucose control. Diabetes damages the small vessels and the nerves that would otherwise warn of damage, so wounds form unnoticed and heal slowly. Venous ulcers form because pooled blood in the leg starves the skin. Pressure ulcers form where bone presses skin against a surface.
Wound measurement and photography, a check for infection and dead tissue, assessment of blood supply to the limb (pulses and Doppler), sensation testing, footwear and pressure assessment, and review of blood sugar with your diabetologist. Vascular surgery is involved early if blood supply is poor.
Conditions treated
Usually under a pressure point in a foot with reduced sensation. Treatment: offloading (footwear, casts or insoles), removal of dead tissue (debridement), infection control, dressings, and — once the wound bed is clean — PRP applied to stimulate healing. Blood sugar control throughout.
Above the ankle, in a leg with varicose veins or previous clots. Compression bandaging is the mainstay; PRP is an adjunct for wounds that stall despite compression. Vein treatment is arranged to prevent recurrence.
Over the heel, sacrum or hip in bed- or chair-bound patients. Pressure relief and nutrition are the treatment; debridement and PRP where the wound bed allows.
A wound that has opened or failed to close after surgery. Infection and tension are addressed with the operating surgeon; PRP to support closure.
[Include only if offered.] PRP to improve healing of partial-thickness burns and the quality of scars.
Wound review and dressing take twenty to thirty minutes. PRP application involves a blood draw, ten to fifteen minutes of processing, and application to the wound with a dressing; the whole visit is under an hour.
Spreading redness, black or foul-smelling tissue, fever, or a cold pale foot. Go to a hospital emergency department today.
Platelets release growth factors that signal the tissue to rebuild. Applied to a clean wound bed, they can restart healing that has stalled.
It can, if the cause remains. Footwear, pressure relief and blood sugar control are permanent measures.
It depends on the wound and the dressing; typically every two to seven days, with PRP applications spaced one to two weeks apart.
Not for most wounds. Deep infection, bone involvement or poor blood supply may need hospital care, arranged directly.
Only in offloading footwear or a cast designed for it. Walking on an unprotected ulcer is the commonest reason it fails to heal.