DEBRIDEMENT & AMNION INJECTIONS IN A NON-HEALING DIABETIC FOOT ULCER
Dr. Doug Toole, DPM
Dr. Toole, co-owner of the Innovation Medical Group in Salt Lake City, is a certified podiatrist through the American Board of Podiatric Medicine.
CASE HISTORY
An 85-year-old female patient with a history of diabetes, vascular disease, and dementia presented at the clinic with a diabetic ulcer on the lateral side of her left foot. After several clinical evaluations, the wound had progressed towards closure, but it stalled with a 0.5 cm opening at the end of the initial treatment. Near-infrared spectroscopy (NIRS) imaging (SnapshotNIR, Kent Imaging) was used to track and document the level of oxygen saturation (StO2) in the wound. This information was used to guide a change in the course of treatment to affect a more effective wound healing process.
OBSERVATIONS
Rapid objective assessment with SnapshotNIR revealed a lack of tissue viability at the lateral side of the left foot helping to explain why the wound was not closing entirely after initial treatment. As a result of this new insight, the clinician immediately altered the treatment plan to help close the wound. The new course of action included a combination of repeated debridement and amnion injections to stimulate vascular neo-genesis. To track and document the wound healing progression, serial imaging was captured using SnapshotNIR. After one week of treatment, the StO2 images captured demonstrated that the area of previous concern was showing improved oxygenation. Debridement and amnion injections were continued for a month until the wound finally closed. This approach saved both time and money and resulted in a much better outcome.
“With SnapshotNIR, we are able to demonstrate the efficacy of an innovative treatment plan in a difficult clinical scenario, helping drive patient compliance while restoring tissue viability in wound healing.”
