Diabetic lesions of the feet Case2

GZD – Danubian hospital, ward 72 (pfl. Dir. Veronika Floigl, St. Ltg. DGKS Christine Liebhart-Weissenböck, Photographic wound documentation: DGKS Eva Zehetner) Space of time from the beginning of the therapy to healing: 2004/01/31 – 2004/04/17

Male, 87 years old. State of mobilisation: Mr. H. moves of oneself by a wheel chair and walkes in his room about 5 to 6 meters on crutches. Localisation of the skin lesion: heels bilateral. Mr. H. is orientated, but at the beginning of the therapy there was a lack of the required compliance to co-operation. Dressings were sometimes removed, especiallaly at night. Not before the healing process was perceptible for him, he accepted the therapy and it was even demanded.
Factors hindering the wound healing are: diabetes mellitus type II, arterial circulatory disturbance, adiposity.

Beginn of the therapy on January, 31th 2004 with a chirurgical removal of the opened vesicae (decubitus state II) with an average bilateral of about 4×4 cm.

Subsequently daily dressing change for about one week by an increased secretory of the wound surface and cleaning with NaCl. Afterwards dressing change as required and beginning of granulation.

Subsequently daily dressing change for about one week by an increased secretory of the wound surface and cleaning with NaCl. Afterwards dressing change as required and beginning of granulation.

In every phase the wound edges were without inflammatory change. The wound edges were manual and without pain for Mr. H. removed by thickening and cornification after a foot bath with essential oils.

In every phase Mr. H. has had a very dry skin, partly squamous, which was treated with a moisture cream.
Antibiotic ointments or disinfectants (as Octenisept or Betaisodona) were never required during the whole phase of wound-healing.