CASE REPORT

“Joaquín Albarrán” Clinic-Surgical Teaching Hospital, Havana city

 

Reporte de caso del Hospital Docente Clínico-Quirúrgico “Joaquín Albarrán”, Ciudad de La Habana

 

 

Lisette Ponce de León, Deborah Beltrán, Edgar George, Alfredo González

Hospital Docente Clínico-Quirúrgico Joaquín Albarrán Ave. 26. Puentes Grandes, Ciudad de La Habana, Cuba

 

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CASE PRESENTATION

RMR patient, aged 56, arrived at “Joaquín Albarrán” Clinic-Surgical Teaching, in Havana City, coming from a rural area, with a calcaneus injure or fissure in the skin, pain, flush, yellowish and fetid secretion, and with fever. Such symptoms evoluted during four days. A glycemia performed at emergency showed 11 mmol/L. The patient was not aware of his diabetes, however, he had family pathologic history. His mother and brothers were diabetics as well, So that he was admited to the hospital, diagnosed neuroinfeccious diabetic foot and debut of diabetes mellitus type II.

During the physical examination a calcaneus access was noticed with abundant slough, yellowish and fetid secretion surrounded by a wide area of cellulitis, spread to the internal mallolus, which measured 10 cm². The wound was classified as grade 3 because of its characyteristics.

SURGICAL TECHNIQUE AND HEALING

The patient was moved to the operating room where the wound was cured and debrided under anesthesia, all the slough was resected, the abscess was drained and also washed with abundant aqueous hibitane solution.

The application of Heberprot-P 75 µg started with intralesional injection, three times a week, together with wound local cure and aqueous hibitane fomentation.

Wound healing evoluted favorable as granulation began on week 4 of the treatment with Heberprot-P. The patient received 27 applications. At 4 months, the wound totally healed.

RESULTS

The patient received 27 doses of Heberprot-P 75 µg. The wound total healing took place at day 120 without relapse (Figure).

SATISFACTION

The patient and his relatives were satisfied and grateful because of the treatment received and the total healing of the wound without sequelae.

Received in July, 2010.
Accepted for publication in August, 2010.

Lisette Ponce de León, Hospital Docente Clínico-Quirúrgico Joaquín Albarrán Ave. 26. Puentes Grandes, Ciudad de La Habana, Cuba