A Nonhealing or Intransigent Phase of a Septic Wound Ulcer on the Left Lower Limb for Over 30 Years without Clinical Diabetes: A Case Report

Abstract

Chronic nonhealing wounds are painful with both psychological and financial cost to the affected patient tied to extensive economic repercussion on society. Here, we present a case of a 54-year-old man who has been living with a painful nonhealing septic ulcer wound for more than 30 years. Clinical examination revealed an extensive septic ulcerative wound on the lower left extremity with multiple ulcerative lesions covering the peroneus brevis, digitorum longus and the foot with erythema and oedema. Doppler scan revealed femoral arteries with thick veins that had undergone 25% stenosis. The left popliteal vein had 25% stenosis with distal obstruction to blood flow with elevated peaks of systolic velocity whiles the posterior tibial artery showed a reduced flow with abnormal waveform and an intraluminal plaque formation of about 50% stenosis. This chronic nonhealing wound requires a more sophisticated wound healing intervention such as arterial revascularisation, debridement, treatment with antimicrobials and organogenesis dressing to permit wound healing. Keywords: Acute and chronic wounds, Septic ulcer, lower limbs, arterial revascularization, debridement, organogenesis dressing, amputation. Read more →