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Houston podiatrist discusses advanced wound dressings to heal a diabetic foot ulcerI'd like to tell you that all diabetic foot ulcers heal easily, but that's far from the truth. My name is Dr. Andrew Schneider, and I'm a podiatrist in Houston, Texas. There are times where we need to use more advanced methods to heal a diabetic foot ulcer.  

So, you have a diabetic foot ulcer. It seems like you've tried everything. You've gone for circulation tests and may even have had a procedure to improve your blood flow. You've tried many different wound dressings with varying results. Where do you turn now? 

I understand how frightening and frustrating it is to treat a diabetic foot ulcer. You know that your foot is at risk as long as the foot ulcer remains. Healing the ulcer removes that risk. When you've tried multiple gels, sheets and powders to get your wound to heal, I'm sure each provided varying results. When I see a wound not responding to conventional wound treatments, I move to the next level of wound dressings. 

The next level of dressings for your diabetic foot ulcer involves biosynthetic skin substitutes. These are dressings comprised of cells  grown in a lab. When it arrives in the office ready to be applied, it looks similar to tissue paper. But they support wound healing by reestablishing a healthy wound environment and provides the cells and nutrients that your body needs to repair the damaged tissue and ultimately heal the wound. 

Applying a skin substitute is easily done in the office. Unlike a true skin graft, there's no surgery involved and no anesthesia required. I first clear the wound bed of all unhealthy and devitalized tissue. Once a healthy wound bed is present, I apply the skin substitute. It adheres to the wound bed and ultimately will be absorbed and incorporated into it. There's no suturing necessary. A gauze dressing is applied to cover and protect the wound. Unlike the more conventional treatments where you change the dressings daily, you keep this dressing clean and dry until I see you again in the office. I usually assess the wound weekly. At that point, more debridement is done and, if necessary, another skin substitute would be applied. 

There's another advanced wound dressing that has me intrigued due to the phenomenal results I've been having with it. The treatment is called Actigraft and it utilizes the resources found in your own blood. Your blood is drawn in the office and injected into a mold that contains clotting factors. It clots and creates a biological dressing using YOUR blood and YOUR growth factors. I then apply the clot directly on the wound and apply a secondary dressing over it. It's just another technology to provide a more advanced wound dressing. 

The time it takes for one of these advanced wound dressings to heal your foot ulcer varies. It unfortunately is a question that can't be answered with any real confidence. It depends on the size and location of the wound and the amount of pressure it receives from standing and walking on it. Complete healing may take anywhere from a few weeks to months of treatment.