K.B.

6/20/03  1st visit

This 65 year old hypertensive diabetic female presented with a painful blister on the lateral aspect of her left 5th digit at the pip-j which in the last week progressed to a sever infection of the whole digit and 4( inter space and cellulitis.

Plan:

Augmentin 875 mg.  10 days

Culture wound

Debride devitalized tissue

Clean digit with Carrington cleanser

Apply biO2 Oxy-Mist treatment with oxygen and spray wound for 5 minutes

Apply dressing

Hydrogel

Adapetic

Gauze dressing

Instruct patient to return for Oxy-Mist treatments 3 times per week

Patient to monitor and control blood glucose

Subsequent visits:

This infected 4th inter space began to heal on the 4th visit and 30 days later was almost healed. On August 3, 2003 the 5th digit is almost healed with only a 1.2cm x 1 .Ocm ulcer and dorsal fissure that is epithelializing. This patient was negative of osteomyelitis of the 4th & 5th ray as confirmed by radiographs and CAT scan.

Emma Byant, M.D.