Clinical history
57-year-old female with a history of recurrent neuropathic ulceration.
She had had a successful two stage surgical reconstruction of her left foot in 2022. However, a year later the patient developed an ulcer underneath the head of the left 1st metatarsal. It was pressure related and was probed to the sesamoid. 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.
Treatment
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 a 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.
Outcome
At 6 months, the wound had almost closed and the patient and healthcare professionals were pleased with the outcome. The patient was relieved she did not have to have further surgery to remove the metal work.
Note: See
STIMULAN page for regulatory statements. MA0460R2
