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J Wound Care. 2019 Jan 1;28(Sup1):S14-S17. doi: 10.12968/jowc.2019.28.Sup1.S14.

The use of bioactive glass S53P4 in the treatment of an infected Charcot foot: a case report.

Author information

1
Department of Orthopedic Surgery, Hospital Israelita Albert Einstein, São Paulo, SP, BR; and Departamento de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.
2
Departamento de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil; and Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
3
Fellow of Department of Orthopedics Foot and Ankle, Hospital for Special Surgery, New York, NY, US.
4
Southwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, US.

Abstract

OBJECTIVE::

To report a case of successful limb-salvage staged treatment in the treatment of an infected diabetic Charcot foot.

CASE SUMMARY::

A 45-year-old male with long-term, uncontrolled type 2 diabetes, six months' history of progressive deformity on the right foot and 45 days of purulent drainage in the lateral aspect of the foot. Patient was diagnosed with an infected Charcot foot with extensive midfoot bone involvement as shown by radiographic and MRI images. We used a multidisciplinary approach to treatment with early antibiotic therapy, tight glycaemic control and staged surgical treatment. Initial treatment was adequate irrigation and debridement, bone-void filling with bioactive glass, external fixation and provisional negative pressure wound therapy (NPWT). Later progressed to total contact casting and progressive protect weight bearing. At final follow-up, patient was full weight-bearing in stiff soled footwear, with no clinical signs of infection, no gross alteration of gait pattern and demonstrating complete bone healing and integration of the bioactive glass.

CONCLUSION::

The bioactive glass S53P4 was successfully used in the limb-salvage staged treatment of a patient with an infected Charcot foot. Here, full integration with the surrounding bone and its supportive action in the combat of bone infection was demonstrated.

KEYWORDS:

Charcot foot; bioglass; osteomyelitis; preservation; principles of management

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