Application Post-Surgical Charcot Deformity Under NPWT

Endoform™ Natural

Adam Silverman, DPM

Silverman Podiatry, Baltimore, Maryland
Initial Presentation
Week 28

Results

  • Significant tissue fill of defect
  • Re-epithelialized by week 28

Patient details

55-year-old male

Medical history

  • Diabetic
  • Left foot diabetic foot ulcer, positive for Group E Streptococcus
  • Charcot deformity

Case details

  • Wound age: 2 years
  • Previous Treatments: NPWT, HBO, TCC, IVAB
  • Treatment: Sharp debridement
  • Wound Size: 6.5 cm x 9 cm x 2.5 cm

Application photos

Initial Presentation
Week 0 – Post-debridement

  • Intravenous Antibiotics
  • Endoform Natural applied, plus a contact layer, under NPWT
  • Wound Size: 9 cm x 6.5 cm x 2.5 cm
  • Case Notes: Exposed tendon

Week 1

  • Endoform Natural and NPWT
  • Beefy red granulation tissue
  • Some residual Endoform in the wound bed (arrow)
  • Evidence of epithelialization at the wound margins
  • Wound Size: 8.2 cm x 5.8 cm x 0.4 cm

Week 1 - Application Tip

  • Apply Endoform
  • Cover with a non-contact layer
  • Apply NPWT over the Endoform

Week 3

  • Endoform Natural plus NPWT continued
  • Endoform incorporating into wound bed
  • Advancing epithelial tissue
  • Wound Size: 8.5 cm x 5.2 cm x 0.3 cm

Week 17

  • NPWT discontinued
  • Endoform Natural reapplied, and foam dressing added under a TCC
  • HBO
  • Epithelial tissue covers half of the wound
  • Wound Size: 4.3 cm x 3.2 cm x 0.1 cm

Week 24

  • Endoform Natural reapplied, and foam dressing added under a TCC
  • Wound size dramatically decreased
  • Wound Size: 1 cm x 0.9 cm

Week 28

  • 100% Re-epithelialization
  • Wound Size: Healed

Results may vary. Dr. Adam Silverman has a consultancy agreement with Aroa Biosurgery Limited.

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  13. Data on file
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