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case_images: Wound status after debridement, vancomycin-loaded bone cement implant, and negative pressure wound therapy installment. (A) After sharp debridement; (B) After resection of non-viable bone and application of the vancomycin-loaded bone cement implant; (C) After negative pressure wound therapy installment.
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case_images: Physical examination revealed an ulcer of approximately 1.5cmx0.5cm on the left medial midfoot with purulent discharge (Figure 1A). The space left by bone resection was filled with antibiotic-loaded bone cement (Figure 1B). The exposed bone had been successfully closed although there was no significant reduction in the size of ulceration (Figure 1C).
case_images: Autologous platelet-rich gel (APG) preparation and the topical administration over the wound bed. (A) APG was prepared after evaluation and informed consent obtained; (B) The gel was administered onto the surface of the wound.
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case_images: After full evaluation and informed consent was obtained, autologous platelet-rich gel (APG) was prepared as described in our previous study (Figure 2A) and the gel was administered to the surface of the wound (Figure 2B).
case_images: Ulcer healing and follow-up. (A) Wound status after the second autologous platelet-rich gel treatment; (B) Complete wound closure was observed after a treatment period of nearly 5 months; (C) Foot condition at the 1 month follow-up; (D) After the intervention, and 1 year after she left the hospital, the patient was without ulcer recurrence.
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case_images: The wound was significantly improved after twice administrations for the treatment of APG (Figure 3A). Complete wound closure was achieved nearly 5 months after a combination of treatments (Figure 3B). There was no sign of ulcer recurrence at follow-up 1-month (Figure 3C) and one-year (Figure 3D) after wound closure.
case_images: Biomechanical parameter improvement following treatment with offloading therapeutic footwear. (A) Biomechanical parameters including ankle angle, hip angle, center of mass, gait, and balance before wearing the custom-made footwear; (B) Changes in biomechanical parameters after wearing the custom-made footwear.
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case_images: Biomechanical parameters, including gait and balance, were assessed before and after therapeutic offloading footwear were worn (Figure 4) (DaveMed LLC, Chongqing, China).