If bone is not exposed, surgery may be avoided. If infection occurs, or if pain becomes unmanageable, then amputation at a level likely to heal should be performed. Open wounds should be managed carefully. Wet to dry dressings should be discontinued when scar tissue begins to develop. Many new dressing products are available for use in these delicate tissues, such as hydrogels.
Pain management is imperative, as pain itself can decrease blood flow into the affected area.
Some wounds in ischemic tissues will heal eventually. The assessment of healing potential and the assessment of vascular disease are related. If possible, the physician can make an assessment using two non-invasive methods, Doppler toe pressures and transcutaneous oximetry. Doppler toe pressures can be obtained with relatively inexpensive, hand-held devices or via hospital vascular laboratories. A disadvantage of this technique is that it requires a small blood pressure cuff to be inflated around the digit, which can be very painful in ischemic toes.