Dr. Steven Silverman retired as of March 2026. Drs. Ulloa and Arosemena of Vascular Wellness Institute are now available and taking new patients. Same office, same friendly faces, and a new lens on your vascular care!

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Medically Reviewed By:

2026-05-01

  • Symptom Severity: Emergency
A wound on the leg or foot that has not healed in two or more weeks may signal critical arterial or venous disease. Delayed treatment significantly increases the risk of infection, gangrene, and limb loss. Contact our office today at (941) 312-6196 or seek emergency evaluation if the wound is infected, spreading, or associated with fever.

Non-Healing Wounds

Also Known As: arterial ulcers; venous ulcers; a chronic wound
A wound that fails to heal within four to six weeks despite standard wound care is a non-healing wound — also called a chronic wound — and requires vascular evaluation. The vast majority of chronic leg and foot wounds have a vascular cause: inadequate blood supply (arterial ulcers), elevated venous pressure (venous ulcers), or a combination of both. Identifying and treating the underlying vascular disease is the essential first step to achieving wound healing and preserving the limb.

Non-Healing Wounds & Vascular Ulcers — Care in Sarasota & Bradenton, Florida

Types of Vascular Wounds

Arterial Ulcers

Arterial ulcers result from critically reduced blood flow to the skin and underlying tissue, causing tissue death. They are typically painful, punched-out, pale or black-based ulcers with minimal drainage, located on the toes, heel, or bony prominences of the foot. They are a manifestation of critical limb ischemia from advanced PAD and require urgent vascular revascularization — not just wound care — to heal.

Venous Ulcers

Venous ulcers account for 70–80% of chronic leg ulcers and result from chronic venous hypertension caused by incompetent vein valves in varicose veins or post-thrombotic disease. They are typically shallow, irregularly shaped ulcers with irregular borders and significant drainage, located on the gaiter area of the lower leg (medial ankle). They are managed with compression therapy, wound care, and treatment of the underlying venous disease.

Diabetic Foot Ulcers

Diabetic foot ulcers develop in patients with diabetic neuropathy and peripheral vascular disease. Numbness from neuropathy allows repetitive pressure injury to go unnoticed; reduced blood flow prevents healing. The diabetic foot is highly susceptible to infection, and diabetic foot ulcers are the leading cause of non-traumatic lower-extremity amputation in the United States. Florida’s large diabetic population makes diabetic foot care a critical public health priority throughout Sarasota and Manatee counties.

Non-Healing Wound Care in Sarasota & Bradenton

Our approach to non-healing wounds begins with a complete vascular evaluation — ABI measurement, arterial and venous duplex ultrasound, and CT angiography when revascularization is being planned — to identify and address any circulatory deficiency driving the wound. Without restoring adequate blood flow, no wound care intervention will reliably succeed.

Wound care includes debridement of necrotic tissue, infection management with targeted antibiotics, advanced wound dressings (foam, alginate, collagen, negative pressure therapy as appropriate), and offloading of pressure for plantar wounds. Our vascular surgeons coordinate care with wound care specialists, podiatrists, and infectious disease consultants to provide comprehensive limb salvage care.

SYMPTOMS

  • Wound on the leg, ankle, or foot that fails to heal after 2 or more weeks
  • Wound margins that appear pale, black, or non-viable (arterial)
  • Wound surrounding heavily pigmented, leathery skin near the ankle (venous)
  • Pain at rest or minimal pain despite wound severity (neuropathic)
  • Signs of infection: increasing redness, warmth, swelling, discharge, or odor

RISK FACTORS

  • Diabetes mellitus (neuropathy + impaired healing)
  • chronic kidney disease
  • smoking
  • obesity
  • steroid use
  • malnutrition
  • prior limb injury or surgery
  • chronic venous insufficiency
  • peripheral artery disease (inadequate blood supply)

DIAGNOSIS METHODS

  • Ankle-Brachial Index (ABI) +

    Essential to determine if arterial insufficiency is contributing to wound failure — ABI <0.5 indicates critical ischemia.

  • Duplex Arterial and Venous Ultrasound +

    Maps arterial inflow and venous outflow to identify the vascular cause.

  • CT Angiography +

    Detailed anatomy when revascularization is planned to restore blood supply to the wound.

  • Wound Culture and Assessment +

    Identifies infecting organisms to guide antibiotic selection.

TREATMENTS

RELATED SYMPTOMS

FREQUENTLY ASKED QUESTIONS

  • When should I see a vascular surgeon for a wound that won't heal? +

    Any wound on the lower leg or foot that has not healed within four to six weeks, any wound in a patient with diabetes or PAD, any wound associated with pain at rest or with minimal activity, and any wound showing signs of spreading infection (increasing redness, warmth, swelling, or systemic fever) warrants prompt vascular evaluation.

  • Can a wound on the leg really require bypass surgery? +

    Yes. When an arterial ulcer is caused by critical limb ischemia, revascularization — lower extremity bypass surgery or endovascular angioplasty — is often necessary before the wound can heal. No amount of wound dressing will compensate for absent blood flow to the tissue.

  • What is the risk of amputation if I have a non-healing wound? +

    The risk depends on the underlying cause, adequacy of blood supply, presence of infection, and whether revascularization is feasible. With prompt and appropriate vascular treatment, limb salvage rates exceeding 85–90% are achievable even in high-risk patients. Delay in treatment — particularly in the presence of infection — substantially increases the risk of amputation.