Case 3

Diabetic Foot

Dr. Marian Pis

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

Diagnosis

Osteomyelitic metatarsal bone in CLTI R5 patient

Duration of the treatment

16 days

Product Used

Patient Details

72-years old polymorbid patient, female, with arterial hypertension, type II diabetes, diabetic foot syndrome (right foot), critical limb threatening ischemia of right lower limb, obese, with metabolic syndrome, after endovascular treatment of femoral artery in 2019, after femoro-profundal bypass graft surgery (prosthetic graft) and femoro-popliteal distal bypass graft surgery (composite graft- prosthetic proximal, venous distal part) in march/2022, after transmetatarsal amputation in march/2022, with obliteration of bypass graft of unknown date, revised in april/2023 (trombectomy and venous component graft to tibiofibular tract), with neuropatic ulceration above the Ist. metatarsal bone with osteomyelitis.

April/2023 reamputation of osteomyelitic I.st metatarsal bone and on 28th april 2023 start of the locat treatment with Vulnamin PWD. Patient took antibiotics targeted directly to Pseudomonas aeruginosa (cultured from the osteomyelitic bone) for 14 days. X-ray showed no residual osteomyelitis. In 14th july 2023 (after 78 days of treatment) there was complete wound healing achieved. There´s no reulceration or reccurency to this day. Limb salvage was achieved.

Neuropatic ulceration of right foot, with osteomyelitis and fistulation, positive probe-to bone test (8th march 2023)

Osteomyelitis of Ist. metatarsal bone with massive secernation (11th april 2023)

Massive granulation tissue above the amputated Ist. metatarsal bone, wound nearly closed (26th may 2023)

Complete wound healing and limb salvage achieved after 78 days of treatment with Vulnamin PWD (27th june 2023)

Dr. Marian Pis