Lower Extremity Edema and Lesions Not Responsive to Conservative Therapy

Abstract

A 66-year-old man with at least 2 years of progressively worsening unilateral left lower extremity edema and recurrent episodes of cellulitis of the anterior left lower leg, treated repeatedly with diuresis and antibiotic therapy, was referred by his rural family physician to the community paramedic (CP) service for diuresis, compression wrapping, wound care, and self-management education. His medical history included prior stroke with residual left-sided hemiplegia; insulin-treated type 2 diabetes complicated by peripheral neuropathy, retinopathy, and stage 3b chronic kidney disease; and obesity with body mass index 39 kg/m.