Foot ulcer treatment depends on what is stopping the wound from healing. Care involves wound cleaning and debridement, advanced wound-healing techniques, pressure redistribution and infection management.
When poor blood supply or venous disease contributes to the ulcer, the treatment also involves vascular assessment and addressing the underlying circulation problem.
The assessment covers the wound, foot structure, pressure distribution, sensation, and, if needed, arterial and venous Doppler.
At CIIVES, DrNB-trained vascular surgeons and podiatric foot-care specialists work together at KIMS – Kingsway Hospitals, Nagpur, to identify the cause and plan treatment around it.
Specialists for Foot Ulcer Treatment in Nagpur
A foot ulcer specialist looks beyond the wound to the factors that worsen it or stop it from healing. Depending on the ulcer, this means wound care, podiatric assessment, vascular evaluation, or a combination of these.
At the CIIVES department, KIMS – Kingsway Hospitals, Nagpur, foot ulcer care involves coordination between podiatric and vascular specialists.
Vascular Surgeons
The vascular surgeon evaluates circulation, including signs of poor blood flow and arterial or venous disease, and performs revascularisation when required.
Dr Rohit Gupta
Vascular & Endovascular Surgeon
Dr Kartik Gupta
Vascular & Endovascular Surgeon
Podiatrist
The podiatrist assesses the factors associated with the foot itself:
- Wound characteristics
- Foot structure
- Pressure distribution
- Footwear
- Gait
- Sensation
Dr. Preeti Gupta
Podiatrist and Diabetic Foot Surgeon
This coordinated approach benefits patients travelling to Nagpur from nearby cities such as Wardha, Amravati, Akola, Yavatmal, Chandrapur, Chhindwara, Seoni, Betul, Balaghat, and Jabalpur.
When Should You See a Specialist for Foot Ulcers?
Many patients in Central India leave primary care without relief because systemic causes of poor healing, such as anaemia, liver disease or kidney disease, are often missed.
Knowing when a wound needs more than routine care helps avoid this delay.
Patients should seek specialist assessment for foot ulcers when:
The nonhealing ulcer
- Not healing after 2–4 weeks
- Getting larger or deeper
- Exposed tendon, joint or bone
- Recurrent ulcer
Signs of infection
- Increasing redness, warmth or swelling
- Discharge or foul odour
- Fever
- Systemic signs
Signs of poor circulation
- Black or blue tissue
- Reduced pulses
- Cold foot
- Colour changes
- Suspected PAD
Neurological risk
- Numbness, tingling
- Burning sensation
- Loss of sensation
Foot Ulcer Treatment in Nagpur
Treating a foot ulcer requires the expertise of both a podiatrist and a vascular surgeon, especially when wound healing is delayed by factors like pressure, neuropathy, arterial disease, or venous insufficiency.
CIIVES combines these through its dedicated Diabetic Foot Care Clinic and vascular team.
The DFCC functions within the CIIVES department’s vascular services, allowing patients with diabetes-related ulcers and significant vascular disease to receive comprehensive treatment.
The specialised care at DFCC includes:
Wound Care and Debridement
- Remove dead, damaged or infected tissue when indicated to create a healthier wound bed and support healing.
- Clean the ulcer and select dressings based on wound depth, tissue condition, drainage, and infection status.
- Non-healing wounds may require advanced wound therapies such as negative-pressure wound therapy.
Offloading and Footwear
- Reduce pressure on the ulcer to prevent repeated tissue damage and support healing.
- Use appropriate footwear, insoles, casting or other offloading methods based on ulcer location, depth and pressure pattern.
- Assess abnormal gait and pressure distribution when these contribute to repeated ulceration.
Infection Management
- Assess the ulcer for local infection, spreading inflammation and systemic signs such as fever or worsening weakness.
- Clinically infected ulcers require antibiotics, while abscesses or infected tissue may require additional drainage or surgical removal.
- If infection extends into deeper tissues or bone, imaging and further evaluation may be needed to guide treatment.
Restoring Blood Flow
- Poor arterial blood flow can prevent an ulcer from healing even when wound care and offloading are appropriate.
- Vascular assessment is important when pulses are reduced, the wound is non-healing, or signs of limb ischaemia are present.
- Doppler studies and other vascular imaging can identify significant arterial disease and help determine whether revascularisation is needed.
The CIIVES department provides vascular interventions, including peripheral angioplasty and revascularisation, when inadequate blood flow is limiting wound healing and limb salvage.
Types of Foot Ulcers
Foot ulcers can have different causes based on additional underlying pathologies, and some wounds have multiple contributing causes.
Neuropathic Ulcer or Diabetic Foot Ulcer
Nerve damage, most often from diabetes, reduces the protective sensation. Repeated, unnoticed pressure on specific sites like the sole or toes breaks down the skin and prevents existing wounds from healing.
Arterial Ulcer
Arterial ulcers develop when inadequate blood flow causes tissue ischaemia. They are often associated with peripheral artery disease and can occur around the toes, foot margins or other areas exposed to reduced perfusion. Pain, cool skin, colour changes and reduced pulses can provide important clinical clues.
Venous Ulcer
Venous ulcers result from impaired venous return and sustained venous hypertension. They are more commonly found around the lower leg and ankle, although foot involvement can occur. Varicose veins, chronic venous insufficiency and post-thrombotic changes can contribute.
Mixed Ulcer
Some patients have both arterial and venous disease. This makes assessment especially important because treating only one circulation problem may not address all causes of delayed healing.
Neuropathic
Arterial
Venous
Mixed
Causes of Foot Ulcers
Foot ulcers can develop from a single underlying condition or from several factors working together.
Common causes include:
- Arterial problems: Peripheral artery disease and high blood pressure.
- Venous problems: Varicose veins and deep vein thrombosis.
- Chronic kidney disease: Reduced kidney function affecting tissue health and healing.
- Liver disease: Portal hypertension and altered venous pressure.
- Anaemia: Reduced oxygen delivery to tissues.
- Diabetes: Nerve damage, poor circulation and delayed healing.
- Combination of causes: Multiple conditions contributing to persistent ulcers.
The Journal of the Association of Physicians of India highlights that lower-limb ulcers are not limited to diabetes. This 2017 study of non-diabetic patients at a tertiary hospital in Mumbai examined ulcers arising from different underlying conditions, supporting the need to identify the cause rather than treating the wound alone.
Take Home Message
Successful foot ulcer treatment requires treating the wound and identifying why it developed or failed to heal. Debridement, appropriate dressings, infection control and offloading can support wound healing, but they cannot correct significant arterial insufficiency or untreated venous disease.
A vascular assessment is particularly important when an ulcer is non-healing, recurrent or associated with reduced pulses or other signs of poor circulation. At the CIIVES department, vascular surgeons and podiatric foot-care specialists work together to address wound care, circulation, pressure and limb-preservation needs as part of the treatment plan.
FAQs
Can a Diabetic Foot Ulcer Heal Without Surgery?
Yes, some diabetic foot ulcers heal with appropriate wound care, infection management, pressure offloading and management of the factors affecting healing. However, an ulcer associated with significant arterial insufficiency may require revascularisation to improve blood flow.
The need for surgery therefore depends on the ulcer’s depth, infection, circulation, tissue viability and response to conservative treatment
Can Poor Blood Circulation Cause a Foot Ulcer?
Peripheral artery disease can reduce blood flow to the foot and impair tissue repair, allowing even a small wound to progress or remain non-healing. Reduced pulses, rest pain, colour changes, cold feet and persistent wounds can raise suspicion of arterial insufficiency. Vascular testing helps determine whether inadequate perfusion is contributing to the ulcer.
Who Treats Foot Ulcers in Nagpur?
Foot ulcers can require coordinated care rather than a single specialty. A podiatrist can assess the wound, foot structure, pressure, gait and offloading requirements, while a vascular surgeon evaluates arterial or venous disease and performs revascularisation when indicated.
At CIIVES, Dr. Preeti Gupta provides podiatric and wound-care services, while Dr. Rohit Gupta and Dr. Kartik Gupta provide vascular and endovascular care relevant to circulation-related and non-healing foot ulcers.