CASE STUDY - 1

This 43 year old African American male is seen after being recommended for above the knee amputation of the left lower extremity. A chronic diabetic ulceration secondary to an incision and drainage has been present for approximately 3 months. Previous treatments included whirlpool therapy as well as normal saline wet to dry dressings. The patient has experienced below the knee amputation the right lower extremity 2 years prior.

A social history of cigarette smoking ( one pk/ day) was significant.

The patient was treated with aggressive wound debridement, anti-biotics, diet modification and preventive education.

 

 
CASE STUDY - 2
This 48 yaer old African American female presented requesting a second opinion after being recommended for amputation of the right lower extremity. The patient states she experienced trauma to the affected foot after a car door was accidentally slammed on her foot. Subsequently a wound developed that became infected. The patient was treated at a local hospital with betadine soaks and normal saline wet to dry dressings.

Initial evaluation revealed that the patient had pulses that were easy to feel by touch. Additionally, the affected foot had digital hair, a sign usually indictative of a viable foot. Clinically, a superficial abscess with a large amount of drainage was evident. After aggressive incision and drainage and surgical removal of all devitalized tissue was performed, the affected extremity was dressed with moisture retaining wound dressings.

The wound was then skin grafted and the patient resumed her normal daily and employment activities.
 
CASE STUDY - 3

This 51 year old African American male was seen with a small ulceration to the bottom aspect of the right foot. The patient admits to pulling skin from the area about one week prior. After several days, the top of the foot became hot, red and swollen. The patient was admitted into the hospital with fever, elevated blood sugars and "flu like" symptoms.The patient has a 15 year history of diabetes.

The patient was taken to surgery and it was determined that the patient had a form of the "flesh eating bacteria" also known as "necrotizing fasciitis". All devitalized tissue was removed to the level of healthy bleeding tissue.

The patient was treated with IV anti-biotics and daily dressing changes. Live cells were used in the form of a product called "Dermagraft" to heal the massive ulceration.

 
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