Case study for HBOT A 68 yr old gentle man was referred to the foot clinic with swelling over the left foot. He was a known diabetic for 25 years. On examination he had cracks over his heel and there was bogginess at the deepest crack.As I inserted a needle with syringe at the highest point, pus was drained out from it. He had severe peripheral sensory neuropathy and on arterial Doppler there was diffuse atherosclerotic disease of the leg vessels. He was admitted and a broad spectrum antibiotic was started. His heel was opened at the crack and pus was drained out through a small opening. But next day on pressing the wound pus came out again so he was taken to the operation theatre for a deep debridement under anesthesia. The wound was thoroughly debrided and this time there was bleeding from the wound and the wound bed looked pink in color. But on the very next day there was blackening at the borders and it was debrided again. This blackening and then debriding continued for another 2 , 3 times. In spite of multiple debridement and culture specific antibiotics the wound bed was not looking healthy at all so a decision to send the patient for hyperbaric oxygen therapy was taken. Only after a few HBOT sessions the blackening stopped and wound bed color improved. Patient was discharged with oral antibiotics and offloading shoes. HBOT continued for almost 22 sessions and later dressings were done till the wound healed completely. In conclusion, HBOT has changed the outcome in this patient and proved very useful in healing of this diabetic foot wound.
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