Introduction and importance
A diabetic foot ulcer (DFU) is one of the major diabetes complications that may lead to limb amputation. Amputation can have profound physical and psychological effects on an individual's life. Nowadays, the prevention of limb amputation and treatment of DFUs are known as the major health challenges.
Case presentation
The present case report is of a 72-year-old woman with a 20-year history of type 2 diabetes who has had asymmetrical and superficial DFUs with sizes of 6 × 5 cm and 3 × 3 cm on the heel and the sole of the right foot, respectively. The ulcers were infected by
S. aureus
and
E. coli
. The patient had been hospitalized several times for receiving treatment, and not only the ulcers had not been healed, but also they had considerably extended so that the risk of foot amputation had been greatly increased. The patient was transferred to our wound care service. After conducting one session of surgical debridement, the patient underwent ten sessions of maggot therapy (one session every two days) using sterile
Lucilia sericata
. After about six months, the patient's DFUs were completely healed.
Clinical discussion
DFU can affect a patient's quality of life and lead to infection, sepsis, amputation, and even patient death. Therefore, using effective treatment approaches is very important for the management of DFUs.
Conclusion
The combined use of surgical debridement and maggot therapy is a safe and effective method for improving diabetic foot ulcers and preventing amputation.
Surgical site infection (SSI) increases length of treatment, delays wound healing, increases antibiotic use and causes patient death in severe cases. This case was a boy aged 38 weeks and 4 days with a birthweight of 2100 g, a height of 42 cm and a head circumference of 32 cm. Twelve days after birth, he was admitted to hospital where a surgeon removed a sacrococcygeal teratoma. The surgical site became infected, and the infection failed to improve despite him receiving routine normal saline dressings twice a day and intravenous antibiotic therapy. The authors started treatment using an antibacterial wound dressing containing honey (Medihoney) on the SSI twice a day for a month. The infant's SSI was wholly healed after 3 months, and he was discharged from the wound treatment team in good general condition. This case shows that SSIs can be treated with honey-containing antibacterial wound gel, especially in infants who have weaker immune systems.
Highlights
Post-tourniquet syndrome is a common reaction to prolonged ischemia.
The prolonged placement of the tourniquet causes the tissue ischemia and necrosis.
Intelligent tourniquet can prevent the complications of prolonged placement of tourniquet.
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