A Case Study Of Complicated Diabetic Foot
(from 19 - 2 - 2007 to 9 - 4 - 2007)

A female, 65 years old from Gandhinagar – Gujarat, known diabetic on irregular treatment, had history of glass injury at plantar surface of right foot before 20 days. She had history of fever with rigor & with swelling & redness of right foot since 3 – 4 days.  She was admitted to civil hospital, Gandhinagar where she was diagnosed to have cellulitis with developing wet gangrene of right foot. She was conservatively treated with debridement of necrosed part, IV antibiotics, Insulin & supportive care. She developed gangrenous changes in right foot, so she was advised to undergo amputation. Then she was taken to Amba Health Centre, where she had fever, diarrhea, and vomiting & foul smelling pus discharge from wound, present on plantar surface of foot which was about 6cm wide & 10cm long & other wound present on dorsal surface of foot was about 2cm wide & 4cm long with cellulitis in surrounding area. She was treated with multiple regimens (Holistic approach) including Allopathic, Ayurvedic, Homoeopathy treatment & Ozone therapy.

Allopathy: She was given IV antibiotics, insulin, daily dressing (with H2O2 & Betadine) with analgesic & supportive care.

Homoeopathy: Hepar sulph 200 which is an antibiotic & it also helps in healing of tissues.

Ozone therapy: Ozone outflow rate at 500ml, with ozone Concentration at 60 mcg/ml up to 30 minutes for 2 months.

Ayurvedic treatment: Ayurvedic Medicine which include Abhayadi Quath & Gaumutra Ark.

After Ozone therapy, daily dressing was done with Panchavalk Quath & sudha Tankan (Ayurvedic medicine) followed by regular dressing for 15 days.

On admission to Amba Health Centre:

                                       
                 

                       (a)                                    (b)                                       (c)

           

                     (d)                                                     (e)

  • Wet gangrene present on plantar surface of foot & other wound present on dorsal surface of foot, (a&b).
  • Full thickness wound with superficial involvement which includes complete loss of epidermis, dermis, fascia & muscles but no bony involvement, (d & e).
  • Seropurulent, foul smelling discharge was present, (c,d & e).
  •  Cellulitis in adjacent area was present, (a).
  •  Wound status: - Contaminated with slough tissues, (d & e).
  • After 3 week of management:

  •          
                               (a)                                                      (b)

                                                                
                    
                                     (c)                                                    (d)

     

    • Wound is improved from full thickness to partial thickness wound which includes loss of epidermis, dermis, and fascia, (a, b & c).
    • Serosanguineous discharge was present without foul smell, (a, b & d).
    •  Cellulitis in adjacent area is reduced, (a, c & d).
    • Wound status: - Healthy wound with little slough tissues. Granulation  tissue is formed along the entire border of wound, (a, b & c).

                                                                    

    1. After 5 Weeks of management: -

      

            

                                          (a)                                                             (b)

           

                                (c)                                                                                (d)

             
     
                       (e)                                                                                 (f)

    • The wound, on dorsal aspect of foot is fully recovered with fascia, dermis, and epidermis, (a). The wound, on plantar aspect is improved with healthy granulation tissue & fibrous tissue, (b, c & d).
    • Serous wound discharge was present from the wound present on plantar aspect of foot, (d, e & f).
    • Cellulitis was absent, (a, b & d).
    • Wound status: - Healthy wound without slough tissue, (d, e & f). Dorsal wound is fully healed, (a).
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