Wound Care Foot & Ankle Michigan

Chronic foot and ankle wounds that fail to heal represent one of the most serious — and most preventable — complications in podiatric medicine. At Balance Foot & Ankle, Dr. Tom Biernacki DPM provides comprehensive wound care for foot and ankle conditions in Michigan at our Howell, Brighton, and Bloomfield Hills locations, including advanced wound dressings, sharp débridement, total contact casting, and coordination with vascular surgery when needed.

Types of Foot & Ankle Wounds Treated

• Diabetic foot ulcers: The most common cause of non-traumatic lower-extremity amputation. Risk is dramatically reduced with early intervention.
• Venous stasis ulcers: Shallow, irregular wounds on the lower leg caused by venous hypertension. Require compression therapy and wound débridement.
• Arterial (ischemic) ulcers: Punched-out, painful wounds from peripheral arterial disease. Require vascular evaluation before local wound care.
• Pressure ulcers: Wounds from sustained pressure on bony prominences — common in neuropathic and bedridden patients.
• Post-surgical wounds: Dehiscence (wound opening) after foot or ankle surgery requiring wound management.
• Traumatic wounds: Lacerations, puncture wounds, and degloving injuries of the foot and ankle.

Our Wound Care Approach

Wound assessment — At each visit Dr. Biernacki measures wound dimensions (length × width × depth), photographs the wound for objective tracking, evaluates granulation tissue, and assesses signs of infection (erythema, warmth, drainage, odor). Wound probing identifies exposed bone or tendon, suggesting osteomyelitis or deep space infection.

Sharp débridement removes necrotic tissue, wound biofilm, and callus from wound margins using a scalpel and curette. Débridement is the single most effective intervention for stimulating wound healing — it removes the bacterial burden and stimulates the wound edges to advance inward.

Total contact casting (TCC) is the gold standard for healing neuropathic diabetic foot ulcers. A well-molded cast distributes plantar pressure evenly across the entire foot, reducing pressure at the ulcer site by 85–90% compared to ambulatory devices. TCC heals 70–90% of uncomplicated plantar forefoot and midfoot diabetic ulcers within 6–8 weeks.

Advanced wound dressings — appropriate moisture management is critical. Dry wounds receive moisture-retentive dressings (hydrogel, hydrocolloid); wet, draining wounds receive absorptive dressings (foam, alginate, silver-containing antimicrobial dressings). Dr. Biernacki selects the appropriate dressing for each wound type and stage.

Bioengineered tissue and advanced therapies — for wounds that fail to progress with standard care after 4 weeks, Dr. Biernacki coordinates access to bioengineered skin substitutes (Apligraf, Dermagraft), platelet-rich plasma application, and hyperbaric oxygen therapy through affiliated Michigan wound care centers.

When to Seek Urgent Wound Care

Seek emergency or urgent podiatric care immediately for: spreading redness or warmth (cellulitis), dark discoloration or black tissue (gangrene), foul odor, visible bone or tendon, rapidly worsening pain, fever, or chills. These signs suggest deep infection that may require hospitalization and surgical intervention to prevent limb loss.

Frequently Asked Questions

Schedule your wound care evaluation at Balance Foot & Ankle in Howell, Brighton, or Bloomfield Hills, Michigan. Dr. Biernacki provides same-week or same-day urgent wound appointments.