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Neurology (Expert Forum)
Unhealing ulcer in non-sensation foot
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Unhealing ulcer in non-sensation foot
by hudhud, Apr 13, 2007 12:00AM
I am a 34 year old male, my general health is good, six years ago I had an injury in my left foot resulting from a screw, the ulcer did not heal easily, I did several operations to ensure the absence of any foreign body. After doing the last operation (last July), the doctor had asked me to walk on my heel to prevent any pressure on the ulcer. The ulcer had fortunately healed, but another ulcer has developed in my heel. This ulcer is still unhealed, I saw a neurology doctor, who examined my feet and found that I have already lost my sensation in my left foot (neuropathy). He asked me to do an (MRI Lumbosacral spine, and cervical spine), the result was the presence of a small intradural lipoma at level of L5, with the tethered cord reaching the level of L4. The lipoma was removed through an operation, which the doctor described it as (a peventive operation), and it will not bring back my sensation to my left foot.
An ortho doctor has suggested to do casting on my left foot with the ulcer area being opened for dressing (using a rocker). He argued that this will prevent the pressure on the ulcer in order to heal, and this is also done with diabetic patients. I did the casting three days ago and waiting for the results (perhaps after one month).
I read from the internet about (The Anodyne Therapy System), which uses infrared radiation to inhance the poduction of NO (nitric oxide), which influence wound healing by increasing vasodilation, promoting cell division and proliferation, angiogenesis, collagen formation and collagen cross-linking.
The ortho doctor says this system is good for diabetic patients, and may not be good for me.
An ortho doctor has suggested to do casting on my left foot with the ulcer area being opened for dressing (using a rocker). He argued that this will prevent the pressure on the ulcer in order to heal, and this is also done with diabetic patients. I did the casting three days ago and waiting for the results (perhaps after one month).
I read from the internet about (The Anodyne Therapy System), which uses infrared radiation to inhance the poduction of NO (nitric oxide), which influence wound healing by increasing vasodilation, promoting cell division and proliferation, angiogenesis, collagen formation and collagen cross-linking.
The ortho doctor says this system is good for diabetic patients, and may not be good for me.
Doctor's Answer
by Forum-M.D.-SH, Apr 26, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
Chronic poorly healing ulcers can be common in patients with neuropathies, and are often very difficult to treat. The standard therapy is to remove the pressure from the involved area and to spread any additional pressure broadly around the foot. I agree with your doctor that a casting to remove the heel pressure is likely going to help. There are a number of other less proven but promising therapies that can also help re-healing, including infrared therapy and hyper-baric oxygen. These treatments have been best characterized in diabetes, but have been used widely in non-healing ulcers with some success. I only caution that you should engage the therpies we have the best information for (as you have) first and use the others as adjunct therapy.
I hope this has been helpful.
Chronic poorly healing ulcers can be common in patients with neuropathies, and are often very difficult to treat. The standard therapy is to remove the pressure from the involved area and to spread any additional pressure broadly around the foot. I agree with your doctor that a casting to remove the heel pressure is likely going to help. There are a number of other less proven but promising therapies that can also help re-healing, including infrared therapy and hyper-baric oxygen. These treatments have been best characterized in diabetes, but have been used widely in non-healing ulcers with some success. I only caution that you should engage the therpies we have the best information for (as you have) first and use the others as adjunct therapy.
I hope this has been helpful.
----------------
The questions that are waiting for an answer are:
Q1: Is there a link between healing and sensation (or neuropathy)?
Q2: Can the idea of casting (so as preventing the pressure on the ulcer) help healing the ulcer? and if not, what do you suggest?
Q3: Is (The Anodyne Therapy System) suitable for my case? or is just suitable for diabetic patients?
----------------
The questions that are waiting for an answer are:
Q1: Is there a link between healing and sensation (or neuropathy)?
Q2: Can the idea of casting (so as preventing the pressure on the ulcer) help healing the ulcer? and if not, what do you suggest?
Q3: Is (The Anodyne Therapy System) suitable for my case? or is just suitable for diabetic patients?
Thank you
I bought a far infrared pad, the Thermotex, and have been very pleased.
You can google for information and vendors.
Carol