57-year-old female with a history of recurrent neuropathic ulceration. Initially she had a first stage reconstruction for infection followed by a left foot Charcot reconstruction (second stage) 2 months later.
1 year later the patient developed an ulcer underneath the head of the left 1st metatarsal. It was pressure related and was down to the sesamoid depth. There were signs of clinical infection. The patient had a fever and the foot was hot, red and swollen. The patient’s existing metalwork was at risk and therefore IV antibiotics were started. Swab results revealed Group B Strep and Anaerobes.
The ulcer was surgically debrided and a partial sesamoidectomy was performed. A bone biopsy revealed Enterobacter cloacae and Anaerobes. STIMULAN
mixed with antibiotic was packed into
the wound and covered with non-adherent dressing.
At 3 weeks, oral antibiotics were stopped. After 3.5 months, the wound was further debrided and a further application of STIMULAN was packed into the wound.
After 5 months, the wound had significantly decreased in size to less than 0.2cm².
At 6 months, the wound had almost closed and the patient and healthcare professionals were happy with the outcome. The patient did not have to have further surgery to remove the metal work.
Note: See STIMULAN
page for regulatory statements. MA0460R1