Welcome to the Gotham Wound Care Center.

The Gotham Wound Care Center is a comprehensive outpatient treatment center for patients with all types of wounds of the leg, foot and ankle. In the future, we will be expanding to treat wounds of other parts of the body, however, for now we are limited the extremity of the foot & ankle.

We are staffed at our current location by board-certified podiatrists. We work very closely with other specialties, such as vascular surgery and plastic surgery. We also work very closely with primary care physicians and endocrinologists.

We most often treat wounds of the lower extremity related to diabetes and vascular diseases. However, we treat wounds also associated with many different pathologies.

Every wound is different.

At your very first visit we will create a customized approach to your wound care. Our specialists will first identify the cause of your non-healing wound. Once the cause of the wound is identified, a treatment plan is devised to improve the underlying factors that are keeping the wound open. Once optimized, we will perform treatment, usually on a weekly basis, to get the wound to get smaller and eventually heal.

Some examples of the methodologies that we used to reduce the size, and heal wounds include: offloading pressure points, controlling infections, edema control, removal of unhealthy tissue, optimizing vascularity, innovative dressing materials, innovative topical applications, skin grafting including cellular biological topicals, hyperbaric oxygen, and the new DermaPACE procedure.

Additionally, our surgeons are well versed in knowing when surgical intervention, whether early or later, is indicated. Plus many more methodologies.

Common causes of wounds we treat.

Diabetic Wounds

Diabetic wounds are the most common cause of wounds that we treat.

Patients with diabetes are prone to getting wounds for a few reasons. Diabetes causes peripheral nephropathy which does not allow the patient to feel pressure or injury that results in breakdown of skin. When the sugar is high, diabetics also have problems fighting off infections which often spread, causing more tissue destruction. Additionally, when sugar is high, the body has a hard time producing new tissues to heal wounds.

Vascular Disease

Vascular diseases are the second most common type of wounds that we see and treat. There are a few different types of vascular disease which lead to wounds.

Arterial disease is disease of the artery system comprised of blood vessels that lead the oxygen and nutrient rich blood away from the heart, and to the periphery of the body. Oxygen and nutrients are important for healing wounds and producing new tissue. Hardening of the arteries results in less blood flow to the areas that need it most. When the arteries get blocked, tissues that are supplied by them start to die leading to localized gangrene.

Venous disease is disease of the veins system that leads blood back to the heart from the periphery of the body. Since there is no pump to push the blood up against gravity, and back to the heart, another mechanism takes place. Through movements of the muscles and the slight negative pressure system, the blood returns to the heart. There are valves within the veins that only allow the blood to flow in one direction. When these valves fail to function, the blood flows the wrong way due to gravity and accumulates. When the venous system does not function properly, the improper flow of blood ends up causing swelling and pitting edema. Swelling and edema are a major factor in venous wounds.

Lymphatic disease is similar to venous disease. The extracellular fluid needs to return to the bloodstream from the periphery as well. Again, since there is no pump to push, it has to move against gravity by other methods. Also similar to veins, the valves within the lymphatic vessels can fail. When the lymphatic vessel system does not function properly, fluid pools in the lower extremities and causes swelling and pitting edema. Swelling and edema ares a major factor in lymphedema wounds.

Post Surgical Complications

When surgical wounds do not heal properly, it is called wound dehiscence. There are many reasons for a wound to open up after surgery after the incision has been sutured closed. Oftentimes, it is difficult to heal dehisced wounds due to underlying medical problems, edema and the trauma of surgery.

Postsurgical wounds are seen very often at the wound care center. We have numerous surgeons that refer us their postsurgical wound complications so that they can concentrate on the actual surgery and not have to worry about the postoperative complications.

The most common type of postoperative complication that we see is postoperative wound infection.

Trauma

Infection

Normally, microorganisms such as bacteria, are found all over the skin. The skin acts as a barrier to entry. When there is a break in the skin, bacteria is allowed to enter into the body. Our immune system usually fights off bacterial infections, however, sometimes, it unable to prevent the spread of the bacteria.

Once inside, bacteria can spread and destroy local tissues including skin, fascia, tendons, ligaments, and eventually bone.

Our first goal at the wound care center is to control and stop infection. This is achieved through the use of oral or IV antibiotics, cleansing, debridement, flushing & packing, and surgery.

Once the infection is under control, we then address the actual wound. Since every wound is different, we first formulate an individual plan for every patient, in order to get the wound to heal.

Sickle Cell

Osteomyelitis

Referring physicians

At the Gotham Wound Care Center, we get referrals from many different types of physicians.

Endocrinologist and Internists.

The most common types of referrals we get are diabetic patients from endocrinologists. We are also given many referrals of diabetic patients from internists and family doctors.

Podiatrists.

Although we are podiatrists, we receive many referrals from other podiatrists. Many podiatrists are trained and skilled treating wounds, but rather would not in their offices. They prefer to send their wound care patients to our wound care center for treatment. Wound care is very time consuming and usually requires weekly treatments. Referring their wound care patients to us leaves them with more time to treat the other elective pathologies that they prefer.

Surgical complications.

Another common referral we get is the treatment of postoperative wound complications after surgery. While every surgeon is knowledgeable and skilled in the treatment of postoperative wounds, they also prefer to send these patients to our wound care center. Again, wound care can be very time consuming. Referring their postoperative complications to us, leaves them more time to treat other pathologies and to do surgeries. They know that their patients be well taken care of at our wound care center, and once they are healed, we send the patients back to the original surgeon for continued care.

Urgent Care Clinics and Walk-in Clinics.

We also see many patients that are referred to us from urgent care and walk-in clinics. These patient usually have wounds that are due to some kind of mild trauma or a laceration. Urgent care clinics see many more small and superficial wounds than the emergency room does. The model of the urgent care clinic is to treat a patient acutely to stabilize them, and then to refer them out for continued care. We work very closely with urgent care clinics to ensure that patients with lacerations and wounds are well taken care of going forward after the acute episode.

Team Approach

At the Gotham Wound Care Center, we use a team approach to healing wounds. Our physician specialists work closely together along with our nurses and administrative staff to provide a superior approach to wound care.

The Gotham Wound Care Center is currently in transition. We are awaiting the opening of our new flagship office in Midtown Manhattan.

Currently, we are only staffed by podiatrist physicians. Once we move to our new location, will have a comprehensive team of podiatrists, vascular surgeons, plastic surgeons, general surgeons, endocrinologists, internal medicine physicians, orthotics and prosthetics pedorthotist, noninvasive vascular testing laboratory, and hyperbaric oxygen.

Until we move into our new office, all these specialties are available at different locations via referrals.