Supplementing Diabetic Wound Care With Hyperbaric Medicine

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Adam R. Johnson, DPM

Case Study: When A Patient With Diabetes Has An Involved Infection With Gas Gangrene

A 66-year-old male with type 2 diabetes mellitus had an involved infection with the presence of subcutaneous gas gangrene in the lateral foot. The patient subsequently had a wide margin excisional debridement and partial fifth ray resection. The resulting foot had an exposed bone of the fourth metatarsal shaft and the fifth metatarsal base as well as concerns of further tissue loss occurring due to local ischemia.

   The patient immediately began treatments in the HBOT chamber due to his gas gangrene infection. The TcPO2 results showed a reading of 21 mmHg in the presence of room air with a significant improvement to 46 mmHg when the patient was breathing 100% O2 via a nasal cannula. Shortly after the initial debridement, the patient returned to the operating room for conversion to a transmetatarsal amputation of the foot due to the presence of exposed bone and advancing distal ischemia and necrosis of the foot.

   The patient’s foot responded well after one month of treatment and healed completely after the completion of the 60 HBOT treatments.

   Dr. Johnson is the Director of the Chronic Wound Clinic at the Hennepin County Medical Center in Minneapolis.

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   For further reading, see “A Guide To Hyperbaric Oxygen Therapy For Diabetic Foot Wounds” in the December 2007 issue of Podiatry Today.

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