PMC7335304_01
Wound status after debridement, vancomycin-loaded bone cement implant, and negative pressure wound therapy installment. (A) After sharp debridement; (B) After resection of non-viable bone and application of the vancomycin-loaded bone cement implant; (C) After negative pressure wound therapy installment.
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Physical examination revealed an ulcer of approximately 1.5cmx0.5cm on the left medial midfoot with purulent discharge (Figure 1A). The space left by bone resection was filled with antibiotic-loaded bone cement (Figure 1B). The exposed bone had been successfully closed although there was no significant reduction in the size of ulceration (Figure 1C).
Autologous platelet-rich gel (APG) preparation and the topical administration over the wound bed. (A) APG was prepared after evaluation and informed consent obtained; (B) The gel was administered onto the surface of the wound.
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After full evaluation and informed consent was obtained, autologous platelet-rich gel (APG) was prepared as described in our previous study (Figure 2A) and the gel was administered to the surface of the wound (Figure 2B).
Ulcer healing and follow-up. (A) Wound status after the second autologous platelet-rich gel treatment; (B) Complete wound closure was observed after a treatment period of nearly 5 months; (C) Foot condition at the 1 month follow-up; (D) After the intervention, and 1 year after she left the hospital, the patient was without ulcer recurrence.
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The wound was significantly improved after twice administrations for the treatment of APG (Figure 3A). Complete wound closure was achieved nearly 5 months after a combination of treatments (Figure 3B). There was no sign of ulcer recurrence at follow-up 1-month (Figure 3C) and one-year (Figure 3D) after wound closure.
Biomechanical parameter improvement following treatment with offloading therapeutic footwear. (A) Biomechanical parameters including ankle angle, hip angle, center of mass, gait, and balance before wearing the custom-made footwear; (B) Changes in biomechanical parameters after wearing the custom-made footwear.
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Biomechanical parameters, including gait and balance, were assessed before and after therapeutic offloading footwear were worn (Figure 4) (DaveMed LLC, Chongqing, China).