Dr Herman, cas de prévention d'amputation de seconde intention

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

Antécédents du patient et consultation

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

Plan et traitement du patient

• Plan
  • Blood Work
  • Arterial Imaging (at facility)
  • Family Discussion
  • Arterial Imaging Same Day for Planning
  • Angiogramme
• Traitement
  • 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