BILATERAL DIABETIC FOOT AND MALLEOLAR ULCERS WITH ENDOVASCULAR INTERVENTION
Erin Buchness, MHL, BSN, RN
Mercy Wound Care and Hyperbarics – a Healogics Clinic, Mercy Hospital, Springfield, MO
HISTORY
59-year-old female patient that sustained a fall, with bilateral open reduction internal fixations of her left and right malleolar fractures completed. Her bilateral ankle incisions dehisced after three weeks prompting multiple rounds of oral and intravenous antibiotics and surgical incision and drainage of her incision sites. The patient’s co-morbidities and relevant medical history included: Type 2 diabetes, coronary artery disease, peripheral arterial disease, peripheral vascular disease and smoking history.
OBSERVATIONS
Within one week, a bilateral arterial duplex was completed with the following reported findings: • 50% - 75% stenosis of the right common femoral artery, occlusion of right superficial femoral artery • 50% - 75% stenosis of the left common femoral artery, occlusion of the left superficial artery Three days later, a left leg balloon angioplasty of the entire superficial femoral artery and proximal popliteal artery, an angioplasty of left tibioperoneal trunk and right common iliac artery, and a bilateral lower extremity angiogram were all completed. Post-intervention, the patient was reimaged with SnapsnotNIR at the foot and ankle sites. The images showed a greater than 15% increase in tissue oxygenation compared to prevascular intervention procedures.
CONCLUSION
By using SnapshotNIR and following the Mercy Springfield Wound Center’s established process and protocol with SnapshotNIR, this patient’s bilateral feet, and possibly her legs, were preserved. We were able to use SnapshotNIR to diagnose her severe peripheral arterial disease and set her on an appropriate plan of care involving cardiovascular interventions, hyperbaric oxygenation therapy (HBOT), and advanced wound care.
“The SnapshotNIR device is efficient and effective and gives us an excellent picture of a patient’s ability to heal.”
