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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What prevents healing of a wound in an elderly diabetic woman with history of prosthetic valve?

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Dr. Bhanu Partap

Cardiologist

Practicing since :2010

Answered : 2084 Questions

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Posted on Wed, 8 Aug 2018 in Hypertension and Heart Disease
Question: My wife was told in May 2017 that she was "diabetic" by a "primary care physician" and was given no instructions on care and maintenance for diabetics. In XXXXXXX 2017 she was given a pedicure in a walk in salon inside a local shopping mall.

In this procedure, the tip of a large toe was "scratched". This was examined and "treated" by a podiatrist employed in a wound clinic at Arizona Heart Institute, a 5 star specialty hospital. After several procedures in six months, the wound has expanded with no clear path forward for remediation.

The (caldera) opening of the wound has now reached 5mm and shows no evidence of closure. The team approach included a procedure to increase venous flow into each foot. Patient, age 82, weight 102 pounds has dual ST. XXXXXXX leaflet, prosthetic valves (1990) is on supplemental oxygen (2 liters/minute).

I'm concerned that the patient is not receiving the best possible diagnosis and treatment. My history includes several years of work in production, sterilization and packaging of IV fluids,
blood collection devices, etc.

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Answered by Dr. Bhanu Partap 1 hour later
Brief Answer:
Please refer to the detailed answer below

Detailed Answer:
Hello Sir

After going through the medical details provided by you of your wife I can very well understand your concern for her health and I would like to tell you that as out age advance the power of healing decrease and above that when someone has diabetes then scenario becomes even worse as diabetes delays wound healing significantly.

In your wifes case age, diabetes and above that anticoagulation which she is on due to a prosthetic valve in place makes healing even more difficult and prolonged.

Although the treatment which she is getting is best of its class. It's just the associated factors which are not in favour.

So in my opinion just help her maintain her sugar levels in good control by having a proper diet and medication regularly.

Strict glyceamic control can only help her heal fast.

Hope to have been helpful.

Kind regards
Dr Bhanu partap
Above answer was peer-reviewed by : Dr. Prasad
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