Return To Research Article

CASE PROFILE

Diagnosis: Diabetes Mellitus with Dermal Ulcer and Osteomyelitis

History:
• 60 year old appraiser
• Diabetic since 1983
• Amputation of 2nd toe (May 2006)
• Subsequent development of ulcer with draining sinus
• Treatment with antibiotics, analgesics, packing and daily dressing changes
• Unable to work or ambulate
• Severe pain and edema of forefoot with cyanosis and impending gangrene

Physical Examination on Presentation at Meditech Clinic:
• Deep infection pre-gangrenous status
• Cyanosis, edema and tenderness of forefoot
• Extensive dressings and packing in place
• Wound draining copiously and severe odour noted

Treatment at Meditech Rehabilitation Clinic:
• Removal of packing and dressings
• Wound left open
• Cessation of all medications
• Saline compresses
• Laser treatment 3 times per week

Progress on the Above Regime:
• After 8 weeks, forefoot presents without edema and only minimal erythema
• Good mobility of toes
• Healing of wound almost complete
• No drainage
• No evidence of inflammation

Most Recent Status:
• Returned to normal activities
• Complete healing of wound

Figures:
• Fig. I to III – Initial status; dry and packing removed
• Fig. IV to VI – Intermediate stage
• Fig. VII to IX – Foot warm, pink and wound almost completely healed