This patient is an 80 yr. old man with a complicated medical history of brittle insulin dependent diabetes mellitus, cardiac arrthymias, cataracts, and hypertension. He also has a history of PVD in addition to diabetic neuropathy and a severe Charcot foot deformity of the right foot and ankle.

He developed this ulcer on his right lateral alleles during the summer of 2003 where multiple modalities were used to try to get it healed and failed. In the late summer/early fall, I started using Amino-Plex® oxygen therapy, oral antibiotics, hydrogel, oasis collagen support, e stim and home treatments with Amino-Plex® spray.

His ulcer initially was very large and deep. With weekly treatments, it was totally healed by Dec 2003 without having to hospitalize him, or worry about osteomyelitis and amputation.

Both patient and family were happy he healed quickly and without serious complications as would be expected. Charcot deformities are extremely prone to skin breakdown and without correct pressure relief and wound closure these extremities have a high reoccurrence rate which sometimes leads to disability and amputation.

DR. HONOR G. MANILLA