Open AccessLimb Salvage with Multiple Modalities: A Case Report of a Diabetic Heel Ulcer Associated with Peripheral Arterial Disease
Author(s) -
Kyoichi Matsuzaki,
Akira Miyamoto
Publication year - 2022
Publication title -
advances in skin and wound care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 61
eISSN - 1538-8654
pISSN - 1527-7941
DOI - 10.1097/01.asw.0000831072.30829.15
Subject(s) - medicine , heel , amputation , arterial disease , surgery , revascularization , peripheral , negative pressure wound therapy , vascular disease , cardiology , alternative medicine , pathology , myocardial infarction , anatomy
A large diabetic heel ulcer with peripheral arterial disease is an independent predictor of limb loss; below-knee amputation is not uncommon in such cases. One treatment is multimodal therapy, which includes partial calcanectomy. Because there is a limit to the ulcer surface area that can be sutured after partial calcanectomy, the remaining raw surface is treated with another method. In this case report, the authors describe a patient with peripheral arterial disease who had a 7 × 9-cm diabetic heel ulcer. The patient was treated with partial calcanectomy after catheter-based endovascular therapy revascularization and then maggot therapy after residual-wound dimensions were reduced by negative-pressure wound therapy.