Wound Care
An ulcer on the foot, ankle or lower leg is a common foot problem that affects many people, particularly those with underlying medical conditions such as diabetes or neuropathy.
An ulcer is an open wound or sore that develops on the skin. Ulcers are caused by many factors including friction, foot deformities, ill-fitting shoe gear, trauma and lacerations. Those with diabetes are particularly vulnerable to foot ulcers due to their compromised immune systems and reduced ability to heal. Ulcers also carry a significant risk of infection as the body is open to infection. If left untreated an infected ulcer can develop into a life threatening infection where amputation is needed. It is crucial to call Brighton Foot and Ankle to have Dr. Castelein treat the area if you suspect you have an ulcer on your foot, ankle or lower leg.
Schedule an appointment today with Dr. Bryant Castelein, DPM – Podiatry Specialist

Wound Care Stages of Healing
Dr. Castelein focuses on treatments to include a range of concepts and principles aimed at promoting optimal healing and reducing the risk of infection.
This may include regular cleaning and dressing changes, the use of antibiotics, and the removal of dead or damaged tissue through surgical debridement.
Wound healing is a complex process that occurs in several phases. The first phase of healing is the inflammatory phase. This phase begins immediately after the wound develops and can last for several days. During this phase, the body’s immune system sends white blood cells to the site of the injury to begin cleaning up dead tissue and fighting infection.
The second phase of wound healing lasts for several weeks and is known as the proliferative phase. During this phase, new tissue is formed and blood vessels begin to grow into the area to provide the necessary nutrients and oxygen for healing.
The final phase of wound healing is called the remodeling phase. The remodeling phase is a long process that can last for several months to a year. During this phase, the new tissue is strengthened and reorganized to constantly improve function, stability, and durability of the skin.
In some cases, the body can become stuck in either the inflammatory or proliferative phases. When a wound becomes stuck in either phase, a delay in the healing process and increased risk of infection occurs. If the body becomes stuck in the inflammatory phase, it can lead to chronic inflammation and the formation of a non-healing wound. In contrast, if the body gets stuck in the proliferative phase, it can lead to the formation of excess scar tissue, which can impair the function of the foot or ankle.
Dr. Castelein is dedicated to providing advanced wound care solutions to patients suffering from foot and ankle wounds. Wound care is an essential aspect of podiatric medicine, involving many strategies designed to promote healing and prevent infection.
Goals of Wound Care at Brighton Foot and Ankle
The ultimate goal of podiatric wound care is to heal the wound as quickly and efficiently as possible to reduce the risk of infection, amputation, and other complications. Dr. Castelein stays up-to-date on the latest advancements and techniques in wound care through continuing education and ongoing training to ensure that our patients receive the best possible care. Dr. Castelein strives to use the best products and procedures available to each patient to achieve the fastest and most definitive treatments.
Brighton Foot and Ankle’s Wound Care
Brighton Foot and Ankle’s aspects of wound care include:
- Debridement: The process of removing dead or damaged tissue from the wound, which promotes the growth of new, healthy tissue
- Offloading: Relieving pressure on the wound, by using specialized footwear or braces.
- Deformity Correction: Often necessary for ulcers caused by foot deformities (such as bunions or hammertoes) as these deformities can cause pressure points that lead to ulcers.
- Dressing Changes: Imperative to keep the wound clean and promote healing.
- Infection Control: These measures are crucial to prevent the spread of bacteria and reduce the risk of infection to the wound.
- Biologics: An additional approach to wound care which uses substances derived from living cells that can help to promote healing. Biologics can include growth factors, stem cells, and other specialized proteins that can aid in tissue regeneration and repair. Growth factors can stimulate the growth of new tissue and blood vessels, while stem cells can differentiate into different types of cells to help repair damaged tissue. Biologics are often used in combination with the other wound care strategies to promote faster and more complete healing.
In some cases, surgical debridement and cleanup may be necessary to remove dead or infected tissue and promote proper healing. This may be done in our operating room to provide a sterile environment and minimize the risk of infection. Dr. Castelein is committed to providing personalized care and treatment plans that are tailored to each patient’s unique needs and goals.
Negative Complications and Importance of Follow-Up Wound Care
If left untreated, foot and ankle ulcers can lead to severe infections, tissue necrosis, and even amputation. The impaired healing capacity associated with certain medical conditions further exacerbates the risk of complications. It is crucial to understand that foot and ankle ulcers should never be taken lightly, as they require prompt attention and appropriate management.
Treating foot and ankle ulcers is a multidisciplinary approach that involves Dr. Castelein working closely with other healthcare professionals. Follow-up care is crucial in managing foot and ankle ulcers, especially for individuals with chronic conditions, such as diabetes. Annual comprehensive diabetic foot exams are essential to identify any early signs of ulcer development and address potential risk factors.
These exams typically include a thorough assessment of foot sensation, circulation and structural abnormalities. By closely monitoring foot health and finding any issues, Dr. Castelein can intervene early and prevent the development of another ulcer or further complications. In addition to foot exams, ongoing foot care education is provided to patients, emphasizing the importance of daily self-inspection, proper hygiene and appropriate footwear choices.
At Brighton Foot and Ankle, patients are empowered with the knowledge and tools necessary to recognize potential problems and seek prompt medical attention.