this young man had a problem where he - hehas diabetes and he stepped on a nail and he got a very serious infection. he got anulcer on the bottom of his foot and it was down here underneath the second metatarsaland then it got an infection and it dissected up here and went all the way across his footand up through his foot. there was a hole all the way through the foot when we firstcleaned this out. it was badly infected. he’s
been on this thing called a wound vac, whichis a negative pressure wound therapy machine for about five weeks and he’s improved alot in those five weeks. in the next couple of weeks we hope to get him back to work andon with his life. he’s a great american, he works hard, takes care of his family, anddoes the right thing. so we’re trying to
get this guy back on his feet.this just shows a lot of different principles of taking care of a diabetic foot, and i’lltalk to you a little bit about those. the first one is, this probably could have beenprevented with appropriate preventative measures like a good insole or a custom made deviceinside the shoe to take pressure off these areas. once he did get an ulcer, that couldhave been treated with offloading with maybe a total contact cast. by some misfortune,he ended up getting a really bad infection. now we’re stuck dealing with a lot of tissueloss, and he’s doing pretty well with that. once we get him back up on his feet, thereare some things we can do to prevent this from ever happening again.
what we’re going to apply now is collagen.what collagen is is the building block - it’s sort of like a scaffold for tissue to growinto. that’s one of the reasons we’ve been able to get this patient to heal so rapidly.he had a lot of tissue loss with a big defect and he’s all filled in now because we’vebeen using this collagen material. collagen is just a white powdery substanceand you just put it on the wound, put it about a quarter thickness. we’re going to putthis sponge on. what this sponge does is the sponge is an open cell foam, which means itall communicates with itself. let’s say you were to put one half of the sponge inthe water and suck on it, the water would come all the way up through the sponge, ifit was all sealed, because that’s what open
cell foam means - it means that it’s openall the way down. this is open cell foam and that’s kind of how it works.now you can see this sponge, it’s all nice and puffy, it’s not squeezed down at all.we cut a hole in this sealer that we’ve wrapped around his foot, attach the part thatgoes to the suction canister, plug that in. what this thing does is it maintains the pressureof negative 125 milliliters of mercury continuously, or you can set it up for alternating pressure.basically, the principle of it is that it increases circulation in the area of the woundby about anywhere from 25-40%, depending on the study that you read. what this does isit dramatically increases the rate of healing that occurs inside this foot. this thing cutsthe healing time probably - with a wound like
Diabetic Foot Infection Guidelines,
the one that you had it would probably havetaken 2-3 months to heal and this has been about a month. with collagen and the woundvac, we’ve really dramatically decreased his healing time so he can get back to workand normal lifestyle. we’ll see you soon, maybe about 4-5 days, ok?
Since you now realize how to control your problem, you will be far better able to make your correct options and modifications in your own life. Keep in mind that these guidelines are only relevant if you use as many of them as is possible, and so you must start today to see quick effects.
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