Non‐Healing Leg or Ankle Wounds



Leg and foot wounds have become a huge problem in the United States and thankfully there are thousands of Wound Care Centers to help with the day to day care of these. However, the main underlying reason to the non-healing of these wounds is a problem with the circulation to the leg/foot. This can be either on the arterial side (delivery of oxygen and nutrients necessary to heal) or on the venous sid​ e. ​ e (removing toxins and fluid). It is felt that about 70% of people who seek care at Wound Care Centers have an underlying circulation issue, and despite going to these places, this problem is often not diagnosed or considered after months of futile debridements and dressing changes. It is critical to have circulation evaluated promptly in any patient over the age of 50, especially if there is a history of smoking, diabetes, or hypertension.

Non-healing leg wounds and ulcers fall into several different categories:

  • Diabetic ulcers: If you have diabetes, you may be prone to foot ulcers since you may not have protective sensation on your feet. Causes of foot ulcers include excessive pressure or rubbing against the skin that may result from wearing ill-fitting shoes or walking barefoot.
  • Ulcers due to arterial insufficiency: Complete or partial arterial blockage can lead to ulcers. If you have arterial disease, you may have tests to measure blood flow or to locate a blockage in your arteries.
  • Venous ulcers: These ulcers are usually a symptom of venous disease, where the veins in your legs are compromised, causing blood to build up. Typical venous ulcers appear near the ankle and are often painful.

South Bay Vascular Center and Vein Institute physicians are recognized as the premiere wound care specialists in San Jose, Silicon Valley and all of Northern California. While podiatrists have always been the traditional starting point for the evaluation of and treatment of non-healing leg wounds,  it is only the Vascular Surgeon who is fellowship trained to be able to evaluate and to treat the underlying cause of most non-healing wounds: poor circulation. Unfortunately, many times skin supplements, hyperbaric chambers and wound debridement are the standard treatment modalities for treating non-healing wounds without consideration of the underlying cause of poor circulation. If you or anyone you know suffers from long term non-healing ankle, foot or leg wounds, South Bay Vascular Center physicians are the leading wound care experts in San Jose and the South Bay and can evaluate the possibility of undergoing a revascularization procedure to address the root cause of this poor circulation. 


Vein problems cause most of the ulcers on the legs treated in wound care centers. These wounds are called “venous leg ulcers”, because they are located in the middle or lower part of the leg, usually above the ankle. These ulcers may be quite large (5-10 cm diameter) and may be “ugly” in appearance, but they are usually not painful. If there is associated pain, the pain is frequently relieved by elevation of the extremity. The skin around these ulcers may be brownish in color and may be firm to touch (not soft and supple), for many years before the ulcer begins. A common cause of leg ulcers is reflux (abnormal blood flow) in the veins of the leg, specifically the saphenous vein.


This problem can be treated permanently by the physicians at South Bay Vascular Center & Vein Institute with an out-patient procedure done in the office. Otherwise, venous leg ulcers tend to recur over time, especially if an appropriate treatment regimen with compression hose has not been followed. With venous leg ulcers, the risk of limb loss is low.


Arterial ulcers, on the other hand, are usually very painful. They are most often located in the foot or toes, i.e. further from the blood flow pump (the heart). Pain is the primary complaint for these patients, especially pain at night if their foot is not kept below the heart. In fact, many patients tell us they sleep with the foot hanging off the bed, to relieve their pain. The wound itself may be small (1-2 cm diameter), and is usually dry. For example, it may be just the tip of a toe. These wounds do not often look as “ugly” as a venous leg ulcer, because there is not enough blood flow to make pus or drainage. The skin around the wound is sometimes red, tender, and swollen, because bacteria can get though the skin and invade the surrounding tissues. This problem needs urgent treatment, and the risk of limb loss is high.


Diabetes patients also frequently get ulcers and wounds of the foot and toes, but that is primarily because of poor sensation (numbness) of the feet. The technical term for this numbness is “peripheral neuropathy.” Many of these patients also have arterial problems, with resultant poor arterial blood flow. This group of patients is at especially high risk of limb loss. South Bay Vascular Center and Vein Institute is recognized as the leading amputation prevention center in San Jose, Silicon Valley and the entire San Francisco Bay Area.  


The physicians at South Bay Vascular Center & Vein Institute are wound care experts, specializing in diabetic amputation prevention and all forms of vascular disease. Therefore, they and are best qualified to determine the cause of a leg/foot ulcer, and will initiate a treatment plan that is best for you. Today, most of the evaluation and even treatment of these issues can be done with the help of our ICAVL accredited vascular lab and our state-of-the –art angiography suite.

Cutting edge care in a state of the art treatment center provides South Bay Vascular Center patients the most advanced care for the treatment of non- healing leg wounds, diabetic ulcers, and gangrene. San Jose's most experienced and best wound care doctors work with most insurances to offer a long term solution to the complications associated with decreased circulation in the lower limbs. 

Call today if you or anyone you know suffers from non healing leg wounds, diabetic ulcers or any other circulatory issue. 


We offer hope when others say there is none.