67-year-old male with type 2 diabetes and BMI of 37 presented with osteomyelitis and interphalangeal joint destruction to his left hallux. This failed to resolve with conservative treatment regime of oral antibiotics and off-loading. Surgical management was to amputate the left hallux, however there was a risk of re-ulceration as he was already receiving treatment for Charcot arthropathy to his right foot.
As a last effort to prevent amputation, surgical debridement was carried out, the bone was fenestrated and STIMULAN used to carry the antibiotic and fill the cavities. Gentamicin and vancomycin were used to treat the infection. Surgery was carried out as a day case under local anaesthetic.
2 weeks post-operatively, the toe reduced in size. At the 16-month x-ray, STIMULAN was seen to be completely absorbed, the patient was infection-free and amputation had been avoided.
Note: See STIMULAN page for regulatory statements.