| 176 |
Case Study
|
Treatment of web space ulcerations with non-contact low frequency ultrasound Amanda L. Odiet, RN, Jenny L. Miller, PT, Steven J. Kavros, DPM, Mayo Clinic, Rochester, MN Background:..Web space ulcerations are a challenge in clinical practice. There is little written in the medical literature pertaining to the standard of care in treatment. They are common in the fourth interspace of the foot. Due to body habitus, the initial development of Intertrigio may go unnoticed in the elderly population. Medical co morbidities, moisture, fungal and bacterial burden increase the possibility in developing ulceration of the web space. Friction of the adjacent fourth and fifth toes adds to the mechanical etiology of the ulceration. The use of non-contact low frequency ultrasound was added to the regimen of standard medical therapy at our facility to attempt to improve healing of web space ulceration Methods:..This case study identified three patients with web space ulcerations. Patients were compromised with diabetes mellitus, peripheral arterial disease, peripheral neuropathy, lower extremity edema and venous insufficiency. Inclusion criteria were: 1) documented index ulcer location and size, 2) use of non-contact low frequency ultrasound after initial visit, and 3) documented follow-up Results:..Three patients healed difficult web space ulcerations with the addition of non-contact low frequency ultrasound when added to their treatment protocol. None of the patients went on to amputation. All patients received topical antibiotic therapy with packing of the wound as indicated during the healing process. Plantar space infection was avoided and limb salvage was maintained Conclusion:..The use of non-contact low frequency ultrasound is a viable therapeutic option to improve the healing of web space ulcerations when added to standard therapy. The use of this technology reduced the healing time in compromised patients and appeared to minimize recurrent infections during the healing process. Most importantly, further aggressive treatment such as amputation was avoided. Amonette RA, Rosenberg EW. Infection of the toe webs with gram negative bacteria. Arch Dermatol. 1973;107:71Ð73 Coughlin MJ. Toenail Abnormalities. In: Coughlin MJ, Mann RA (eds). Surgery of the Foot and Ankle, 7th edition. St. Louis, MO: Mosby, 1999: 1038.. |
|