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

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

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

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

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

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

Day 15

Good granulation, wound was inspected for infection. Legius applied.

Day 16

Good granulation, wound was inspected for infection. Legius applied.

Day 17

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

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

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

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

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