Abstrak:
Diabetic foot ulcers (DFUs) and arterial ulcers are complex wounds that are frequently observed in patients with underlying vascular complications, such as diabetes and peripheral arterial disease (PAD). The treatment of these ulcers is challenging due to the presence of compromised blood flow and prolonged healing times. The objective of this case is to ensure the management of a challenging wound, namely an arterial ulcer with 50% stenosis in the left tibia, through a multidisciplinary approach. Method this case study concerns a 48-year-old male patient with a diabetic foot ulcer that has proven resistant to conventional treatment, in addition to an arterial ulcer that has been further complicated by 50% stenosis in the left tibial artery. A multidisciplinary approach was employed to manage the patient, with input from specialists in vascular surgery, wound care, adjunctive therapy, endocrinology, and rehabilitation. The treatment plan comprised revascularisation via minimally invasive endovascular intervention, advanced wound dressing, infection control, and adjunctive therapy, namely hyperbaric oxygen and metabolic stabilisation. The patient's progress was monitored meticulously, with regular assessments of wound progress, wound healing progress as indicated by the WINNERS Scale Score and glycemic control.
Results the multidisciplinary treatment approach yielded considerable improvement in the process of wound healing, with complete epithelialisation achieved after 11 weeks. The patient's blood flow and glycemic levels were stabilized, thereby reducing the risk of further complications and enhancing the process of wound healing. This case study demonstrates the efficacy of a multidisciplinary approach in the management of complex arterial ulcers with concurrent diabetic foot complications. Conclusion the multidisciplinary management of arterial and diabetic ulcers that are refractory to healing, particularly in patients with vascular comorbidities, has the potential to significantly enhance outcomes. This case study highlights the value of a collaborative approach, which optimises patient outcomes by addressing both the vascular and metabolic factors that are critical to healing.
Page Number: 58