When Not To Use Advanced Wound Care Modalities
- Volume 26 - Issue 5 - May 2013
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Despite being repeatedly advised about smoking cessation, the patient failed to quit smoking, stating “My smoking has nothing to do with the healing.” Additionally, while awaiting custom shoes that had been molded and were pending fabrication, he got explicit instructions to remain in the removable cast boot. However, he presented for a follow-up visit in athletic shoes with a sock wadded up in the forefoot of the shoe.
When questioned in the clinic, he stated, “I just wanted to wear a regular shoe. It isn’t going to be a problem.” He obviously continued to wear the inappropriate shoe and a lateral TMA wound developed. At this point, I referred the patient to orthopedics for a proximal amputation.
Dr. Rothenberg is the Director of Resident Training and an attending podiatrist in the Miami VA Healthcare System.
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