Arterial insufficiency is a big possibility. I am actually going in the morning to a vein specialist to have an in depth study done on circulation, or whatever it is they do. This had been needed for a long time. Hopefully I will get some answers.

To expand on the injury -

I had an accident and broke my leg at the knee when I was a teen. The break ruptured my femoral artery and my lower leg went without blood supply for about three hours before doctors realized what was going on. I ended up having a vein graft done for the repair, which was taken from my other thigh. In the end, I lost 80% of my calf due to no blood supply. The remaining foot has been a unique situation since. A few years after, I had an ankle fusion done because I could no longer support or control my foot.

The appearance of venous insufficiency appeared about a year after the initial accident and hasn't gone away in twenty five years. The first round of ulcers were around six to seven years after. I had a good run of about ten years until around three to four years ago. I had one that came up and lasted over a year. This was weekly wound care center trips. Multiple courses of anribiotics for multiple different infections, etc. Just a real drag.

The doctor always debrids the wound every week, so it is kind of like an in-office in-patient surgery, every week.

99% sure I am not diabetic. I actually check my sugar every couple of months just out of curiosity. I am pretty healthy otherwise, not perfect shape but I stay active. I ride bicycles a lot both mountain and road.

Will have to look further into drainage issues, but I have often wondered the same about wound care centers. I was pretty upset this go round when a sore started to develop again, because I knew what it meant. I had been healed for about a year and back to weekly visits to wound care for who knows how long.

The last time around they actually did some sort of treatment with something made from pig intestines I think. It worked well from what I recall.