Alginate dressings and the diabetic foot ulcer

Abstract

AbstractAlginate dressings derived from seaweed have been widely used in wound management over recent years and we have increasingly noted their use in diabetic foot ulcers. We report a 62 year old lady with insulin‐treated diabetes who initially presented with a superficial ulcer on the sole of her right foot and localised surrounding cellulitis. She was treated with intravenous broad spectrum antibiotics for one week with a good clinical response. Nevertheless, a triple phase bone scan demonstrated underlying osteomyelitis in the second metatarsal head. Conservative management was pursued, using oral antibiotics, a pressure‐relieving Scotchcast boot and continuous drainage via a frequently changed saline wick. However, the saline wick was subsequently replaced by an alginate dressing in the community. She was readmitted with cellulitis of her right foot and an associated abscess which required incision and drainage; later a ray excision of her second toe was performed. It was apparent that the alginate dressing had formed a hard occlusive matt over the ulcer and thus prevented the continuous drainage. Alginate dressings are contra‐indicated in the diabetic foot ulcer when there is a likelihood of underlying infection.