Originally Posted By AFARR:
Patient gave permission to share pics and some info to the public.
Patient was seen in the ER for 'cellulitis'. I was consulted. This is about 2 months ago.
Started as a callus on the bottom of the foot, used 'Ped Egg', a few days later noticed redness and treated with peroxide.
Didn't feel better 2 weeks later...redness on foot going to ankle, soreness to foot, started to get fever/chills....so they went to the ER.
Blood sugars about 400 (and the patient had never been diagnosed diabetic). White count about 16.
Wounds tracked from bottom to top. Puriulence under the necrotic tissue on the top, tracking towards the ankle and towards the big toe.
Did bedside surface debridement, flushed wound with betadine 'solution' (mix of saline/betadine)...took them to the OR the next day, debrided, flushed it well, dressed it.
The wound tracked about the length of my little finger towards the ankle and towards the big toe (under the edge).
Put a wound vac on the wound the next day.
I told the patient that we're going to try everything to save the foot, but you have a high likelyhood of losing a part of, or all of the foot.
This is the patient a few days later at the wound center:
(Yes, that's a tendon you're seeing...and with the 'purplish' color to the little toe, it didn't look like it was going to make it)
Regular wound care, hyperbaric Oxygen treatments (supervised by one of the guys in our practice who is at the wound center regularly)
Today (almost healed...I probably won't see them again). Patient very happy to have an intact foot.