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| Title: | TREATMENT OF A NONHEALING, GANGRENOUS DIABETIC FOOT ULCER WITH BECAPLERMIN AND HYPERBARIC OXYGEN THERAPY. |
| Authors: | Stone, JA Brill, L |
| Keywords: | becaplermin treatment ulcer diabetes hypertension foot HBO |
| Issue Date: | 2000 |
| Abstract: | BACKGROUND: Becaplermin (recombinant human platelet-derived growth factor-BB, rhPDGF-BB) is approved for the treatment of diabetic neuropathic ulcers of the lower extremity that extend into the subcutaneous tissue or beyond, despite adequate circulation. A recent study suggests that becaplermin combined with hyperbaric oxygen (HBO) therapy may act synergistically to enhance wound healing. This case provides further evidence of the beneficial effects of combination therapy with becaplermin and HBO. METHODS: A 68-year-old woman with a longstanding history of adult onset diabetes and hypertension was referred to our care for treatment of a wound that had failed to heal despite 2 months of conventional treatment. Initial examination showed an extensive wound on the dorsum of the right foot, loss of skin and subcutaneous tissue, and visible necrosis of the underlying tendons. The 4th and 5th toes showed frank evidence of gangrene and visible bone. Doppler studies revealed significant peripheral vascular disease. The patient was not a candidate for revascularization. Although salvage of the foot seemed unlikely, aggressive debridement and amputation of the 4th and 5th toes was performed. Wound care consisted of once-daily application of becaplermin and moist saline gauze dressings in conjunction with a course of 24 HBO treatments (protocol: 2.4 atmospheres absolute, 91-120 minutes, 100% O2). RESULTS: After only 4 weeks of becaplermin and HBO therapy, sufficient granulation tissue was present for skin grafting. The graft was successful, and no further amputation was required. CONCLUSIONS: Becaplermin combined with HBO therapy is an effective treatment of this prevalent and serious complication of diabetes. |
| Description: | Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org) |
| URI: | http://archive.rubicon-foundation.org/6603 |
| Appears in Collections: | UHMS Meeting Abstracts
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