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PS, 59/F, diabetic, with severely infected, multiple foot ulcers.

Updated: Jan 25, 2021

This patient has probably the most satisfying result of anybody we have treated at Hilom. When this patient came to us, she had already been to multiple institutions where sharp surgical debridement was done twice and, when the wound would not respond to traditional methods of care, was summarily advised amputation. Examining the patient, it was observed that almost the whole heel and lateral aspect of the foot was affected and the periosteum of the calcaneus, plantar fascia, as well as portions of the tendons of Achilles and Tibialis Posterior were exposed. The wound was very foul-smelling and did not look like it was amenable to non-surgical management; it was totally understandable that amputation was advised.

The patient's expectations of the outcome were tempered and treatment was started, with the only promise given was that we would do our best. The first month of treatment was focused on trying to control and eradicate the infection. Ultrasound assisted debridement with Prontosan was done every treatment session to achieve this, along with the removal of dead and necrotic tissue. After about 4 weeks, there was no longer any trace of foul smell and the infection had been eradicated. It was also around this time that healthy granulation started creeping over the wound bed, covering the exposed tendons and periosteum. The wound edges were also observed to be contracting and the wound was a very healthy bright pink color. The next 2 months of treatment showed accelerated progress and we just rode this progress until we achieved full wound healing after 7 months.