Case 1

Diabetic Foot

Dr. Marian Pis

M.D. – National Institute of Cardiovascular Disease, Bratislava, Slovak Rep


Arterial-venous leg ulcer and diabetic foot osteomyelitis

Duration of the treatment

16 days

Product Used

Patient Details

73-years old polymorbid patient, female, with arterial hypertension, type II diabetes, diabetic foot syndrome (left foot), critical limb threatening ischemia of left lower limb, obese, with metabolic syndrome, with mixed arterial-venous leg ulcer treated unsuccessfuly from 26th september 2023.

On 3rd october 2023 underwent femoral artery endarterectomy and femoro-popliteal distal bypass graft (prosthetic).

On 5th december 2023 is patient diagnosed with bypass graft obliteration and with accelerated CLTI symptomes  including necrosis above Vth metatarsal head of left foot is indicated to surgical revision.

On 12th december 2023 trombectomy and revision of proximal and distal anastomosis was realizied.

From 30th january 2024 mixed leg ulcer was treated by Vulnamin Gel, but patient was diagnosed with osteomyelitis of the fifth metatarsal bone.

On 20th february 2024 was realized an amputation of the fifth toe and exarticulation of fifth metatarsal on left foot. Enterococcus faecalis was cultered from bone and direct antibiotic treatment for several weeks was administered.

On 28th february 2024 treatment with Vulnamin Gel started.

Mixed arterial-venous leg ulcer treated unsuccessfuly from 26th september 2023.

30th january 2023 – start of treatment with Vulnamin Gel, there´s “naked” periosteum without any granulation tissue on 50% of wound bed and stopped epithelisation from margins.

Almost complete graulation achieved on 12th march 2024 and very good start of epithelisation.

After next two weeks (26th march 2024) there´s “explosion” of epithelialisation above fully granulated wound bed

Left foot after the amputation (23rd february 2024)

After 2 weeks of treatment with Vulnamin Gel there´s a significant improvement. Wound bed is fully granulated and wound margins are naturally closing the wound (12th march 2024)

Only 4 weeks afte the start of our treatment, wound is only 3×1 cm and still closing. On X-ray there are no signs of residual osteomyelitis (20.3.2024). We achieved limb salvage for now.

Dr. Marian Pis