chondroitin-sulfates and Osteomyelitis

Diabetic foot ulcers may lead to nontraumatic amputations of the foot, leading to a decrease in patient quality of life. Transmetatarsal amputations (TMAs) represent an effective surgical procedure in cases of severe foot infection, but the tissue reconstruction is complicated and additional procedures should be considered. The present case report evaluates the wound closure of an open TMA in a patient with diabetes treated with a new aerogel composed of chitosan (ChS) and chondroitin sulphate (CS), without needing a skin graft.. A 72-year-old man with diabetes and a history of successive amputations was admitted to a hospital in Valdivia, Chile, due to a severe infection of toes 2 and 4 of the right foot. After the diagnosis of gangrene and osteomyelitis, the patient underwent a TMA of his right forefoot. The surgeon proposed the incorporation of ChS and CS aerogels to accelerate wound healing to avoid another surgical procedure. The TMA surgical wound area closed 50% after day 28 from starting treatment with aerogels. Complete closure was achieved at day 94 of treatment with aerogels, with good epithelial tissue and favorable cosmetic results and without residual limb deformities. The patient experienced minimal physical and psychological impairment from the procedure. Other surgical procedures were not necessary.. Due to the results of this patient, use of ChS and CS aerogels could represent an alternative treatment for forefoot TMA wound closure and prevent further surgical procedures, such as skin grafting. Future works should consider a larger number of cases.

Topics: Aged; Amputation, Surgical; Chitosan; Chondroitin Sulfates; Diabetes Mellitus, Type 2; Diabetic Foot; Gangrene; Gels; Humans; Male; Metatarsus; Osteomyelitis; Wound Healing

Osteomyelitis of the calcaneus is a difficult problem to manage. Patients affected by osteomyelitis of the calcaneus often have a below-the-knee amputation because of their comorbidity. In this article, we present seven cases of heel ulcerations with chronic osteomyelitis treated with Integra(®) Dermal Regeneration Template, skin graft and negative pressure wound therapy after partial tangential calcanectomy, discussing the surgical and functional results. In this casuistic of patients, all wounds healed after skin grating of the neodermis generated by Integra(®), with no patient requiring a below-knee amputation.

Topics: Aged; Aged, 80 and over; Calcaneus; Chondroitin Sulfates; Chronic Disease; Collagen; Combined Modality Therapy; Female; Humans; Male; Middle Aged; Negative-Pressure Wound Therapy; Osteomyelitis; Radiography; Retrospective Studies; Skin Transplantation; Skin, Artificial; Wound Healing

Topics: Adult; Anti-Bacterial Agents; Bone Cements; Calcium Phosphates; Chondroitin Sulfates; Femoral Fractures; Femur; Fracture Fixation, Intramedullary; Humans; Hydroxyapatites; Male; Methicillin Resistance; Osteomyelitis; Postoperative Complications; Staphylococcal Infections; Staphylococcus aureus; Succinates; Vancomycin