| Case
1: |
TOE INFECTION
IN A K/C/O DIABETES WITH CALCIFIED VESSELS AND
ABI<0.9.Patient had no pain at presentation.Otherthan
a Blood Sugar > 250mg%(his normal was less than
140mg% PP), no other abnormal finding was there.
|
|
Before |
Immediate
post debridement |
|
|
After 2 Weeks
|
After 6 Weeks |
|
|
| Case
2: |
K/C/O
OF DIABETES MELLITUS WITH NECROTIZING FASCIITIS.
PATIENT CAME WITH HIGH BLOOD SUGARS, INGUINAL LYMPHADENITIS,
LOWGRADE FEVER, BUT NO PAIN
|
|
|
Before |
After
10 days |
After
8 weeks |
|
|
| Case
3: |
FOOT
INFECTION(WET GANGRENE) IN A DIABETIC WITH LONG HISTORY
OF SMOKING. ON ANGIOGRAPHY, THE SUPERFICIAL FEMORAL
ARTERIES WERE 100% BLOCKED AND PERIPHERAL ARTERIAL
RUNOFF WAS POOR. PATIENT HEALED WITHOUT A BYPASS
GRAFT AND I MUST STRESS ALSO WITHOUT A SKIN GRAFT
|
|
| Case
4: |
WET
GANGRENE IN PATIENT WITH DIABETES MELLITUS, HYPERTENSION,
.90% BLOCKED SUPERFICIAL FEMORAL ARTERY WITH POOR
RUNOFF.PATIENT WAS UNFIT FOR VASCULAR BYPASS
3 DAYS
POST DEBRIDEMENT, A TRANSMETATARSAL AMPUTATION WAS
CARRIED OUT WITHOUT DOING A VASCULAR BYPASS
|
|
12 WEEKS AFTER THE INITIAL EVENT, PATIENT WAS MOBILIZED
IN CUSTOMIZED FOOTWEAR. NO SKIN GRAFTING WAS CARRIED
OUT DURING THE ENTIRE PROCESS OF HEALING |
|
|
| VENOUS PROBLEMS |
| Case
5: |
VENOUS
ULCER->5 YEARS DURATION. Patient was a teacher
who had undergone multiple skin grafting surgeries,
before coming tous.
|
|
Before |
Fully Healed after
12 Weeks |
|
|
| Case
6: |
LONG
STANDING ECZEMA.PATIENT CAME WITH CELLULITIS, LEG
SWELLING AND A NON HEALING ULCER FOR >3 MONTHS.
HE HAD CVI WITH SAPHENOFEMORAL INCOMPETENCE AND MULTIPLE
PERFORATOR INCOMPETENCE WITH NO OBVIOUS SUPERFICIAL
VARICOSE VEINS.
|
|
| ULCERS
WITH MULTIFACTORIAL ETIOLOGY |
| Case
7: |
VENOUS
ULCER WITH PAD WITH
DIABETES & RHEUMATOID ARTHRITIS.
|
|
Before |
Fully
healed after 3 Weeks
|
|
|
| Case
8: |
NON
HEALING ULCER IN PATIENT WITH CHRONIC VENOUS INSUFFICIENCY,
PERIPHERAL ARTERIAL DISEASE & CHRONIC OSTEOMYELITIS
OF THE ANKLE JOINT.
|
|
Before |
Completely
healed at 2 weeks Post surgery
|
|
|
| Case
9: |
NON
HEALING ULCER FOR > 25 YEARS.PATIENT HAD CHARCOTS
FOOT, WITH DEEP VENOUS INSUFFICIENCY AND PERIPHERAL
ARTERIAL DISEASE.
|
|
Before |
Fully
healed within 3 Weeks of Customised Foot Wear
& other supportive treatment |
|
|
One point which I would like to stress
upon, as a rule we avoid doing skin grafts where possible
i.e. 95% of our patients. We prefer natural healing over
skin grafts especially in areas where pressure is bound
to be there like plantar ulcers, patients with deep venous
insufficiency etc. As in these locations graft breakdown
and loss is very common. The cases where we may advocate
skin grafting are large traumatic ulcers and accident
cases where it is important to achieve skin cover as
rapidly as possible |
