Medical History: Mr. B. is a 56-year-old gentleman w/ type II insulin dependant diabetes. Mr. B. suffers w/ recurrent skin tissue break down at the left, lateral aspect of the calcaneous tuberosity (heel) where a myocutanoeus flap was performed in an effort to surgically close a diabetic, neurotrophic foot ulcer resulting from improper foot wear. Unfortunately, Mr. B's surgical flap failed and basically sloughed off.

Furthermore, Mr. B. has extremely decreased sensation bilaterally on the lower extremities. Mr. B. has confirmed lower extremity atherosclerosis. Ankle Brachial Indices (ABI) were performed w/ a hand held Doppler and a blood pressure cuff.

Before attempting wound treatment. More conclusive vascular studies were to follow. Mr. B's ABI @ the Left posterior tibial was .69 and at the Left Dorsalis Pedis . 67. Before coming to us for wound treatment Mr. B suffered w/ this ulcer from 1994 till present. Mr. B.'s ulcer is healed.

Wound treatment involved cleansing w/ NSS. 0.9 % NaCl. Then Amino-Plex®, manufactured by Bio2 Cosmeseuticals was applied BID every 12 hr. An isotonic impregnated hydrogel gauze dressing was then applied and secured w/ conforming gauze and tape. The Left foot ulcer was off-loaded appropriately w/ a customized ankle foot orthosis (Short Leg Cam walker w/ a rocker sole. Plaztezote material was used as a padded insert and modified to suit.

Larry LoDico, Certified Wound Specialist