Wound Care Foot & Ankle Michigan | Ulcer Treatment Specialist

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Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

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.

Most Common Mistake We See

The most common mistake we see is: Waiting too long before seeking care. Fix: any foot pain lasting more than 4 weeks, or any sudden severe symptom, deserves a professional evaluation rather than more rest.

Warning Signs That Need Same-Day Care

Dr. Tom’s Top 3 — The Premium Foot Pain Stack (2026)

If you only buy three things for foot pain, get these. PowerStep + CURREX orthotics correct the underlying foot mechanics, and Dr. Hoy’s pain gel delivers fast topical relief. This is the exact stack Dr. Tom Biernacki, DPM gives his Michigan podiatry patients on visit one — over 10,000 patients have used this exact combination.

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your foot health, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

Frequently Asked Questions

When should I see a podiatrist?

See a podiatrist if: foot or ankle pain has lasted more than 2–4 weeks without improvement, you’re changing your gait to avoid pain, you have an open wound or sore that isn’t healing, you notice nail discoloration or thickening, you have diabetes and any foot concern, or pain is severe enough to wake you at night. Most foot conditions are easier and cheaper to treat early — what starts as a minor issue can become a surgical problem with months of delay.

What is the difference between a podiatrist and an orthopedic surgeon?

Podiatrists (DPM — Doctor of Podiatric Medicine) specialize exclusively in the foot, ankle, and lower leg. Orthopedic surgeons (MD/DO) have broader musculoskeletal training but variable foot/ankle subspecialization. For foot and ankle-specific problems, a podiatrist often has more focused training and experience. For injuries involving the leg above the ankle, complex pediatric cases, or multi-level reconstruction, orthopedic consultation may be appropriate. We frequently co-manage patients with orthopedic colleagues.

How do I know if my foot pain is serious?

Signs that warrant same-day or next-day evaluation: severe pain that appeared suddenly without clear cause, swelling, redness, and warmth that appeared suddenly (possible gout, infection, or Charcot fracture), an open wound that looks infected (redness spreading, pus, warmth), inability to bear weight, or any foot problem in a diabetic patient. Pain that’s been present for weeks and is stable is important but not an emergency — schedule within 1–2 weeks.

Can foot problems cause back and knee pain?

Yes — this is a kinetic chain effect. Abnormal foot mechanics (overpronation, supination, leg length discrepancy) cause compensatory changes in knee, hip, and lumbar alignment. Roughly 30% of patients presenting to our clinic with knee pain have a treatable foot-level biomechanical cause. Correcting foot mechanics with orthotics or appropriate footwear often provides significant knee and back relief. If you have chronic knee or back pain and haven’t had your foot mechanics evaluated, it’s worth a consult.

Are orthotics worth it?

For the right conditions, yes — custom orthotics are among the most cost-effective interventions in podiatry. They’re most effective for: plantar fasciitis, flat feet with secondary knee/back pain, leg length discrepancy, metatarsalgia, posterior tibial tendon dysfunction, and diabetic foot pressure management. Quality OTC orthotics ($35–60) resolve symptoms for 60% of patients with mild-to-moderate conditions. Custom orthotics are appropriate when OTC options have failed or when the biomechanical problem is complex. We cast custom orthotics in-office.

How do I choose the right running shoes?

Start with your foot type (flat, neutral, high arch) and running pattern (overpronator, neutral, supinator). Flat feet and overpronators do best in stability or motion-control shoes. Neutral feet do well in neutral-cushioned shoes. High arches need maximum cushioning with flexible soles. Always buy running shoes at the end of the day (foot swelling peaks then), get properly fitted by a specialist, and replace every 300–500 miles. If you’ve been injured repeatedly, a gait analysis can identify the mechanical flaw driving your injury pattern.

What is the difference between a sprain and a fracture?

A sprain is a ligament injury (the tissue connecting bones); a fracture is a break in the bone itself. Both can occur with the same trauma (ankle roll, fall). The old test — ‘if you can walk, it’s not broken’ — is wrong; many fractures are initially weight-bearable. Key differences: a fracture typically produces localized bone tenderness along the bone itself, while a sprain is tender over the ligament. X-ray is the standard to differentiate. High-grade sprains without proper treatment can be as disabling as fractures.

How do I prevent foot and ankle injuries?

The four most impactful prevention strategies: (1) Supportive, appropriately fitted footwear for your foot type and activity. (2) Gradual activity progression — the 10% rule (never increase weekly mileage or intensity by more than 10%). (3) Regular calf and ankle mobility work. (4) Strengthening the posterior tibial tendon, peroneals, and intrinsic foot muscles. Most overuse injuries are preventable; most acute injuries are not — but ankle sprain recurrence (60–70% without rehab) is prevented by balance and proprioception training.