Hyperbaric oxygen in the treatment of a diabetic foot ulcer.
Although simultaneous pancreas and kidney transplant improves most complications of type 1 diabetes, suppression of the immune system increases the risk for infection. The authors report the case of a patient who, despite receiving a simultaneous pancreas and kidney transplant, subsequently developed neuro-ischemic ulcers of his right foot requiring repeated amputations. He then developed an infected ulcer of his remaining right big toe, with significant implications for his mobility. This ulcer proved resistant to multiple courses of antibiotics and care in a specialist foot clinic but resolved completely following a course of hyperbaric oxygen therapy. The role of hyperbaric oxygen in diabetic foot ulcers is not yet fully established but should be considered in resistant cases with vascular insufficiency and a significant infective component.
Royal College of Surgeons in Ireland Medical School, Beaumont Hospital, Dublin, Ireland. drcdavenport@gmail.com
Colin
C
Davenport
David
D
Carmody
Sean
S
Higgins
David P
DP
Hickey
Diarmuid
D
Smith
D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D017719:Diabetic Foot / Q000628:therapy*; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D006931:Hyperbaric Oxygenation; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation