Case Study: Diabetic Foot Treatment

A disabled, 47 year-old diabetic patient had a wound of unknown cause on her right foot. Her diabetes treatment comprises metformin (hydrochloride) and glucophage-glicazide- diamicron twice-daily. She has walking difficulties for which she wears orthopaedic shoes, and uses a wheelchair for longer distances. Sometimes, her right leg moves involuntarily which might have caused her to bump into something. Due to her diabetes, she suffers from neuropathy in both lower limbs. This means she has no feeling in both her feet and for this reason, the wound had gone unnoticed for two to three months before she called the nurse.

Upon medical inspection, the doctor prescribed 10 days of moxicilline-clamoxyl-1gr twice daily and to treat the wound with fusidate sodium Fucidine-ointment. The treatment made the patient’s foot swollen and inflammation was evident. Since the treatment was evidently unsuccessful, the nurse practitioner convinced the doctor to use the L-Mesitran honey-based ointment. The nurse cleansed the wound daily with 0.05% chlorhexidine. After drying the wound, L-Mesitran Ointment was applied and dressed with a regular gauze. Since the patient wore orthopaedic shoes, the dressing needed to be a thin layer.

The wound produced a lot of exudate from time to time which was difficult to manage due to the orthopaedic shoe. This is the reason the wound evolution shows occasional maceration which could have been avoided if an absorbent dressing would have been used.

In 9 days, the wound was cleaned and inflammation subsided. In a period of about 4 weeks, the maceration was under control. The wound got smaller and showed signs of granulation and epithelialization. A month later, the wound healed completely. Considering the patient was diabetic and wore tight fitting shoes during the wound healing process, this was a remarkable result. In a period of 10 weeks, this diabetic foot wound was completely healed. The healing was without any adverse effects.