Case Report and Literature Review of the Sequential Treatment Involving Percutaneous Transluminal Angioplasty, Tissue-engineered Skin Graft and Negative Pressure Wound Therapy in Dialysis Patients with Diabetic Plantar and Heel Ulcers
Year: 2022
Type: preprint
Study design: Case Report
Abstract: This case report is concerned with a female patient aged 62, who was admitted to the hospital due to the “ulceration on her left foot for more than one month and the pain exacerbation for one week”. Three years ago, this patient underwent regular hemodialysis for treating the “renal failure in the stage of uremia”. This time, she was admitted with plantar and heel ulcers on her left foot, which had caused damage to the lower leg. The digital subtraction angiography (DSA) showed extensive stenosis and occlusion in the left superficial femoral artery, left peroneal artery and left posterior tibial artery, based on which this patient was diagnosed with type 2 diabetic foot ulcers (DFU, TEXAS 4D). After her admission to the hospital, the multidisciplinary team (MDT) concluded from discussion that the flap transposition and transfemoral amputation were not applicable to this case. Therefore, the “straight bloodstream” was opened by endovascular operation towards the affected part on the basis of medical supportive treatment + local debridement. Then, the wound was sequentially repaired by split-thickness skin and tissue-engineered skin grafts combined with negative pressure treatment. Four months later, the wound completely healed, and the patient was able to walk with walking aid. It was the first case in which the ischemic diabetic plantar and heel ulcers were successfully cured by the sequential treatment involving percutaneous transluminal angioplasty (PTA), autologous skin and tissue-engineered skin grafts, and negative pressure suction.
Source: Research Square
Authors: Jinjun Wang, Xianming Huang, Pinyi Wang, Linru Wang, Juanzi Zhang, Qiuxia Liu, Diyu Geng, Wenwen Li, Xiguang Chen
Institution: Ocean University of China
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4229446883