Case 84: Successful Treatment of Ischemia and its Complications

This 79 year old diabetic and former smoker had had a previous femoral-tibial bypass in his left leg and a few years later an amputation of his left second toe. The latter did not heal over 5.7 months. He was advised he was not a candidate for further vascular surgery. His walking was limited to 75 feet. Both legs were treated with Long- and Mini-Boots largely in our Nursing Home Boot facility with relief of his rest pain, improvement in his claudication and healing of his amputation site.

New skin could not cover the necrotic fatty infected material in the base of his amputation site.

The amputation site was injected before his Mini-Boot treatments with appropriate antibiotics to effectively sterilize it and a possible underlying osteomyelitis. The foot was immersed in Sea Soaks again containing appropriate antibiotics during his Mini-Boot treatments gently debriding the lesion without extending its width or depth. His rest pain was relieved and the lesion cured in his left foot. His claudication was improved in his right leg..

A little callus-like material remained at the amputation site at the time of discharge from booting.

Comments: This man was included because his case is relatively straight forward. In one leg a symptom of ischemia alone (claudication) was relieved. In the other leg, complications of ischemia (nonhealing, infection and rest pain) were relieved. When standard measures have failed, how else might he have been successfully treated? Note the improvement in color and nutrition of the skin of the feet.