Case 169: Outpatient Healing of Plantar Neuropathic Ulcer

This 67 year old type 2 diabetic man had a plantar ulcer that had not improved under the care of his vascular surgeon. He had palpable pulses and an insensate foot. He initially was treated in the Mini-Boot with his foot immersed in Sea Soaks containing gentamicin and Urecholine. When his foot began to swell, Vancomycin was injected into the base of the ulcer before the treatments.

He Healed and returned to an ambulatory state. In 1997, he underwent a carotid endarterectomy and coronary bypass surgery. He joined an HMO that provided podiatric care. His podiatrist debrided callus on his left 5th toe, which subsequently became infected. He was hospitalized for a successful partial 5th toe amputation. As of a telephone follow-up on march 10th, 1998, he was home and doing well.

Comments: Cannot prove it.... but willing to bet we could have cured his 5th toe and prevented his hospitalization and toe amputation.