Gangrene
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Distal Tibial and Dorsal Foot
Plaster of Paris applied too tight. Plan: Dorsalis Pedis artery compromised also extensive Gangrene that was debrided. Platelet Rich Plasma (PRP), low-intensity laser treatment with Legius and Sorusal treatment.
Arrival
Gangrene on left lower leg (POP- plaster of paris) wound debridedd. Dead & necrotic tissue was removed. Legius was applied.
Day 1
NuGel was applied to exposed bone & Jelonet was used to cover the exposed tendon. Legius was applied, and wound covered with light cotton & crepe bandage.
Day 4
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and the wound covered with light cotton & crepe bandage.
Day 8
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and the wound covered with light cotton & crepe bandage.
Day 15
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and the wound covered with light cotton & crepe bandage.
Day 16
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and the wound covered with light cotton & crepe bandage
Day 17
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and the wound covered with light cotton & crepe bandage.
Day 19
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and the wound covered with light cotton & crepe bandage.
Day 22
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and the wound covered with light cotton & crepe bandage.
Day 23
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and the wound covered with light cotton & crepe bandage
Day 25
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and the wound covered with light cotton & crepe bandage
Day 55
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and the wound covered with light cotton & crepe bandage
Day 60
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and the wound covered with light cotton & crepe bandage.
Day 80
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and the wound covered with light cotton & crepe bandage.
Calcaneal Region
Plaster of Paris applied too tightly.
Arrival
Gangrene on left lower leg (POP- plaster of paris) wound debrided. Dead & necrotic tissue was removed. Legius was applied.
Day 1
All exposed bone & tendons were covered with NuGel & Jelonet. Legius was put on top & covered with cotton wool bandage and lightly wrapped with crepe bandage.
Day 3
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and wound covered with light cotton & crepe bandage.
Day 8
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and wound covered with light cotton & crepe bandage.
Day 15
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and wound covered with light cotton & crepe bandage.
Day 16
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and wound covered with light cotton & crepe bandage.
Day 17
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and wound covered with light cotton & crepe bandage.
Day 19
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and wound covered with light cotton & crepe bandage.
Day 22
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and wound covered with light cotton & crepe bandage.
Day 23
NuGel was applied to exposed bone and the tendon was covered with Jelonet. Legius was applied, and wound covered with light cotton & crepe bandage.
Day 25
NuGel was applied to exposed bone and tendon covered with Jelonet. Legius was applied, and wound covered with light cotton & crepe bandage.
Day 60
Very good granulation of the wound. Legius was applied.
Day 80
Wound Closed and healed.
Plantar Region
Plaster of Paris applied too tightly.
Arrival
Debrided gangrenous areas in plantar region. Wounds were plugged with Legius.
Day 3
Legius was re-applied.
Day 5
Good granulation, wound was inspected for infection. Legius applied.
Day 15
Good granulation, wound was inspected for infection. Legius applied.
Day 16
Good granulation, wound was inspected for infection. Legius applied.
Day 17
Good granulation, wound was inspected for infection. Legius applied.
Day 19
Good granulation, wound was inspected for infection. Legius applied.
Day 22
Good granulation, wound was inspected for infection. Legius applied.
Day 23
Good granulation, wound was inspected for infection. Legius applied.
Day 25
Good granulation, wound was inspected for infection. Legius applied.
Day 55
Dressing stopped, Wound is healed.
Day 60
Very good granulation of wound. Legius was applied.
Day 80
Wound closed and healed.
Necrotizing Fasciitis
Diabetic patient presented with Necrotizing Fasciitis. Sandwich Dressing: Legius on wound surface and Sorusal on top.
Arrival
Daily bedridement of necrotic tissue. Legius soaked in a Betadine solution was placed on wound bed & plugged with Sorusal. (Sandwich dressing)
Day 2
Betadine was placed on wound bed & plugged with Sorusal. (Sandwich dreessing)
Day 4
Legius was applied.
Day 8
Legius was applied, wound is granulating well, mild sepsis present. Continue with manual debridement.
Day 15
Wound bed is much healthier, good granulation. Legius is applied.
Day 22
Wound ready for refferal to plastic surgeon.
Necrotizing Fasciitis
Gunshot wound. No arrival photo, photo’s start from day 3. Dressing was changed twice a day with Sandwich dressing. (Legius & Sorusal) Sandwich Dressing: Legius on wound surface and Sorusal on top of Legius.
Day 3
Wound is very wet as a result of two drains. Sandwich dressing. (Legius & Sorusal)
Day 5
Wound is very wet as a result of two drains. Sandwich Dressing. (Legius & Sorusal)
Day 19
Skin graft was done on rib region & closed with occlusive dressing and Pseudomonas infection started. Sorusal dressing done.
Day 25
Wound improving. Skin graft appears healthy.
Day 34
Skin graft was done again. Another occlusive dressing was applied causing Pseudomonas infection once again. Sorusal applied.
Day 34
Skin graft was done again. Another occlusive dressing was applied causing Pseudomonas infection once again. Sorusal applied.
Day 40
Infection clearing up. Legius was applied. (Diluted vinegar was applied to kill Pseadomonas)
Day 59
Excellent granulation can be seen. No infection present. Legius re-applied.
Day 80
Wound was completely healed.