Dr. Herman Case Study – A “Second Look” Amputation Prevention [Dr. Herman]

Dr. Kevin Herman helps a 95-year-old patient with a non-healing, painful heel ulcer on the foot to help prevent amputation.

Patient History and Consultation

  • 95 year-old female with recent onset of painful left heel ulcer. Non ambulatory. AAOx3. Conversant. Wheelchair dependent, able to transfer.
  • Past Medical History
    • DVT
    • PAD
    • CHF
    • Afib
    • HTN
    • Gastritis
    • Dysphagia
    • Arthritis
    • Weakness

Patient Plan and Treatment

  • Plan 
    • Blood Work
    • Arterial Imaging (at facility)
    • Family Discussion
    • Arterial Imaging Same Day for Planning
    • Angiogram
  • Treatment
    • IV Abx – Meropenem, broad spectrum antibiotic
    • Anti-plt
    • Cont. current medical mgmt.

Same Day Arterial Imaging

Angiogram 5/5/22

Rationale for Second Look

Second Look Intervention

Initial Angio

Angio @ Second Look

Before and After Images 2 week progression

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