PMC6358405_01
The condition of the patient's lower limb at admission. Multiple ulcers were visible on the medial and lateral sides of the right calf and right ankle. The right foot dorsal ulcer was approximately 7 x 8 cm.
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F1
All ulcers had a significant amount of yellow liquid exudate and odor (Fig. 1).
Trend in C-reactive protein levels during the hospitalization period. When the patient was admitted to the hospital, the infection was fairly serious. We controlled the infection incrementally, and we achieved a C-reactive protein level that was within the normal range (for the detection method used, a level lower than 10 mg/L is normal) on or near the 20th day after admission, after which the level remained stable.
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F2
Figures 2 and 3 show the trends in the changes in C-reactive protein and 2-hour postprandial blood glucose levels throughout the treatment period.
Trend in the 2-hour postprandial blood glucose levels throughout the hospitalization period. We achieved glycemic control within the standard limit (less than 10.0 mmol/L) recommended by the American Diabetes Association for diabetic patients.
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F3
Figures 2 and 3 show the trends in the changes in C-reactive protein and 2-hour postprandial blood glucose levels throughout the treatment period.
On the 9th day after admission, the debridement was performed. The clearly necrotic tissue was entirely removed, while ambiguous tissue was retained.
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F4
The surgeon removed the previously confirmed necrotic tissue and preserved any tissue the necrotic status of which had not been verified (Fig. 4).
On the 21st day after admission, debridement was performed on the wound, and a vacuum sealing drainage device was installed after the operation.
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F5
The surgeon removed the remaining necrotic tissue, washed the wound with a normal saline and hydrogen peroxide, and then installed the vacuum sealing drainage device over the wound, using pressure dressings of sterile cotton pads and elastic bandages to cover the wound (Fig. 5).
On the 32nd day after admission, we saw a promising amount of fresh granulation tissue covering the wound before the skin graft operation.
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F6
We could see a substantial area covered with fresh granulation tissue above the wound (Fig. 6).
On the 56th day after admission, the wound had completely healed.
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F7
On the 56th day after admission, the wound had completely healed (Fig. 7).