How it works
The first visit is an examination and a conversation. Your doctor will assess how deep and how large the ulcer is, check whether there is infection or dead tissue, and ask about your nutrition, your underlying conditions, and the care you have at home. Sometimes blood tests or imaging are needed to find out whether the damage has reached the bone. Surgery is usually considered only after the ulcer is clean and your overall health has been improved as much as possible.
The type of anesthesia depends on the location and depth of the ulcer and on your health; it may be general anesthesia or a regional block. Your doctor will explain which option suits you and why.
During the operation, your doctor first performs debridement, which means removing dead and infected tissue until only healthy tissue remains. If the damage has eaten into the bone, the diseased part of the bone may be removed or smoothed. Then, to close the gap, your doctor often uses a tissue flap, which is a section of skin, fat, and sometimes muscle taken from a nearby area and moved to cover the ulcer. The specific technique is chosen based on where the damage is and how deep it goes.
Once the wound is closed, the area is dressed, and a small drain is usually placed to let fluid escape over the next few days. The recovery plan, especially how to keep pressure off the surgical area, is set from the very start, because this is the key factor in whether the wound heals and stays healed.