ENDOVASCULAR INTERVENTION 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
A 78-year-old male with peripheral arterial disease (PAD) and diabetes presented at the clinic with a non-healing diabetic foot ulcer (DFU). The patient had been treated for several months with a serial advanced wound care regime, including weekly debridement, allograft placement and appropriate off-loading. The patient experienced hospitalizations and was at high risk for amputation.
OBSERVATIONS
Near-infrared spectroscopy (NIRS) imaging with Kent Imaging’s SnapshotNIR was used on presentation to the clinic to document the level of oxygen saturation (StO2 ) in the wound. This imaging illustrated very low tissue oxygenation (StO2 ) impeding wound healing due to low tissue perfusion in the associated angiosome. This information was used to escalate vascular referral and the patient underwent an endovascular intervention to improve flow and oxygen delivery to the tissues. Postintervention imaging captured with SnapshotNIR demonstrated drastic improvement in tissue oxygenation and viability. The StO2 images demonstrate the efficacy of the vascular intervention and show the progress in healing during the course of treatment, from exposed capsular tendon to tissue granulation. These images helped to motivate the patient to adhere to consistent therapy and the final result was complete wound closure.
“With SnapshotNIR, we were able to demonstrate the success of vascular intervention in addition to the efficacy of this advanced wound care regimen. As post-intervention treatment continued, these images confirming regular healing progress helped to motivate the patient to strict compliance leading to complete wound closure.”
