45 y/o male with NIDDM was admitted to the hospital for polysubstance abuse. Podiatry was consulted for management of the large anterior venous stasis ulcer of the right leg. The wound measured 16cm x 14cm and had a fibrogranular base. Positive edema noted, No sinus tracking, no edema, no mal odor, and no erythema. Patients vitals were stable. Anerobic/Aerobic wound cultures were attained. The wound was irrigated and fibrous film over the wound was removed. Collagen matrix product was applied to the entire wound bed, then an Unna boot, followed by cast padding and Coban. Patient was visiting the podiatry clinic previously but did not show up for follow up appointments for at least 3 months. Will change dressings in 3 days.

Uncontrolled diabetes leads to OM.

One week ago a 66 year old diabetic male presented to clinic with ulceration at the plantar aspect of the right hallux. + Probe to bone and thus a bone biopsy was performed. Clindamycin was prescribed for the possible infection. Betadine and DSD was then applied to the wound.

Bone biospy results showed trabecular pattern consistent with osteomyelitis. Vascular consult was ordered to assess the blood flow to the toe and clearance for surgery was granted. Patient is scheduled for a hallux amputation of the right foot.

Previously the patient also had a below knee amputation of his left leg in 2006. Patient does not know what medications he takes for his diabetes and admits to not taking his meds consistently.