Case Study: Avoiding Amputation After Pharmacy Wart Treatment
THE PROBLEM: A WOUND ON HIS LEFT FOOT
- Hilson had an unresolved wound beneath his left 1st plantar metatarsal head (beneath the ball of the foot at the big toe)
- It was caused by the longstanding application of “WartOff” he had been purchasing from the pharmacy, which caused second-degree chemical burns
9 MONTHS OF PAIN & AMPUTATION ADVICE
After nine months of being turned away by four practitioners who did not provide any solution to his pain or involve anyone else in his care, Hilson had taken to trying to manage the pain himself.
Eventually, Hilson did receive a referral to an orthopaedic surgeon, who suggested that he should have a partial amputation of the 1st metatarsal head to try to heal the wound. No further investigations were performed and Hilson was prescribed a single course of antibiotics. Hilson decided to not proceed with the amputation.
AFTER SOME RESEARCH, HILSON CAME IN TO SEE US
IMMEDIATE ACTION REQUIRED
From our findings, Hilson urgently required:
- Antibiotics to help with the current infection
- X-ray to check for osteomyelitis, septic arthritis, sepsis & infection-induced necrosis - all very severe consequences due to the longevity and severity of Hilson’s infection
Thankfully, each of the reports came back clear for the above. They did find degenerative changes to the big toe joint, which may have stemmed from the wound being neglected.
PODIATRISTS & WOUND CARE
Although this is a dermatological case, Podiatrists can play an important role in diagnosing and treating wounds, dermatological conditions, skin concerns, identifying possible skin cancer lesions & help doctors with patient management for all skin, hair and nail concerns - whether diagnosed or not.
HILSON’S TREATMENT PLAN
Hilson needed specific wound care to allow the wound to heal, alleviate his pain and infection, and stop the symptoms from getting worse. We:
- Debrided the dead and infected tissue away from the wound under local anaesthetic to help the wound heal.
- Dressed the wound well with the right antibacterial materials.
- Added padding to greatly reduce pressure directly over the wound.
- Gave Hilson the right dressings and paddings to use at home, and taught him how to best use these.
- Provided Hilson with a medical certificate supplied to excuse him from work for one week due to his inability to wear enclosed shoes.
- Scheduled his review in two days to check and redress the wound, as well as discuss better footwear options that will help him stay more comfortable while his wound heals.
80% of Hilson’s wound healed by 3 weeks, with complete wound closure by 5 weeks after first consulting us. He was cleared for work after two weeks if wearing protective shoes.
Hilson was ‘over the moon’ with his results - and so were we. He now continues to do the work he loves, provide for his family, and has full medical clearance to do anything he’d like without restrictions.