Complex Wound Care & Limb Salvage

Complex Wound Care :: Custom Foot Orthotic Fitting

Complex Wound Care

An injury or small wound over the skin will normally heal within a week or two. However, sometimes due to an underlying medical condition, a small wound on the leg may take months to heal and may even increase in size. Such a wound on the leg that takes more than six weeks to heal is called a chronic leg wound. Chronic leg wounds can become infected and threaten the functionality of the patient’s limb and even life.

Most leg wounds are due to an underlying venous disease that usually affects the legs. Though, in some patients arterial disease or other conditions such as diabetes and rheumatoid arthritis may also cause poor healing leg wounds. In venous disease, the valves in the legs veins do not function properly or are damaged by clots in the vein. This causes the blood to flow backwards resulting in abnormally high pressure in the vein while standing for a long time. This high pressure damages the skin of the legs and leads to small breaks in the skin that develop into wounds.

The treatment of leg wounds involves regular dressing of the wound to promote healing and use of compression bandaging or stocking to reduce the high pressure in the leg veins. During the dressing changes, the wound is also cleaned by gentle washing in either warm water or saline water. Debridement may be performed under local anaesthetic if there is a large amount of dead tissue over the wound which needs to be removed to promote healing. Compression bandage or stockings are to be worn at all times during the day. Whenever possible the legs should be kept slightly elevated above heart level, putting pillows or cushions under the feet while lying down.

The dressing and compression bandages are initially changed once every week. The progress in healing is carefully monitored and the type of dressing used is changed depending on the stage of healing. If the wound is infected a course of antibiotics may be prescribed. Pain medication may also be prescribed, if required. Skin grafting may be considered in few rare cases with very large or treatment resistant leg wounds.

Even after the wound heals, there is a chance that the wound may recur as the underlying problem still persists. Thus the following precautions should be taken to prevent the recurrence of leg wounds:

  • Compression bandages and stockings should be used at all times during the day. Legs should be kept elevated, whenever possible
  • Moisturising cream should be applied regularly, to prevent dryness
  • Eating a nutritious diet and exercising regularly is important for general health
  • If you are obese, talk to your doctor about healthy ways to lose weight
  • Quit smoking as it delays healing

Legs should be regularly examined for any minor skin condition such as blisters, broken skin, swelling or redness and these should be treated at the earliest, to prevent the development of a wound.


Custom Foot Orthotic Fitting

Custom foot orthotics is specially designed corrective devices to restore the natural position of the feet. The orthotics acts as an interface between the feet, the shoe and the ground. The purpose of the device is to support the bones and joints of the feet to maintain optimal neutral position and to eliminate or compensate any misalignments or structural problems of the feet.

Orthotics is usually prescribed by a specialized doctor according to the requirement, lifestyle or shape of the feet of the patient. There are many different types of orthotics such as rigid types to increase the control of the feet and soft or flexible types to provide comfort. Certain specially designed orthotics for different sporting activities provide balance and control during sport, prevents high impact stress or injury to the feet, knees or spine and also enhances performance.

Functions of Custom Foot Orthotic

  • Prevent abnormal foot function
  • Restore proper weight distribution
  • Improve overall biomechanical function of the foot
  • Compensate for deformities or other abnormalities related to leg and foot
  • Prevent further damage of joints, muscles and ligaments
  • Prevents sports injuries and enhance performance


Orthotics is commonly indicated for prevention or correction of various foot conditions. Usage of orthotics depends on the symptoms of the condition ranging from general aches to foot conditions such as achille’s tendonitis, plantar fasciitis, heel spurs, diabetic neuropathy, calluses or corn’s formation, morton’s neuroma and sesamoiditis. Sometimes orthotics is also recommended as an alternative to surgery or may be used after surgery to preserve the alignment.