Application in a Chronic Stage IV Pressure Injury of Heel
Alpash K. Patel, DPM
Podiatric Surgeon – OakBend Medical Center, Richmond, TX Kindred Sugar Land Hospital, Sugar Land, TX
Initial Presentation – Post-debridement
Week 17 – Closed
Results
- Healing confirmed at week 17
- 3 applications of Symphony
- No complications
Patient details
62-year-old male
Medical history
- Peripheral arterial disease
- Diabetes mellitus with severe peripheral neuropathy
- HIV
- Bladder cancer
- History of Charcot neuroarthropathy
- Prior Treatment: Long-term acute care facility on IV antibiotics, multiple debridements, 20+ hyperbaric oxygen dives
Case details
- Stage IV ischemic pressure injury of the left posterior heel with exposed bone, duration of >1 month
- Approximate Size: 5 cm x 5 cm x 1.5 cm
Application photos
Initial Presentation
- Serial debridements performed
- Offloading and infection management
Week 0 - Symphony Application
- Symphony (5 x 5 cm device) hydrated with blood and saline, and placed directly over exposed bone and tissue
- Secured with Steri-Strips™
Week 1
- Symphony continues to integrate, residual product noted
- Evidence of budding neodermis and vascularized granulation tissue noted
- No complications
Week 2
- Symphony continues to integrate.
- Neodermis and vascularized granulation tissue beginning to cover exposed bone
- Symphony reapplied
- No complications
Week 4
- Robust neodermis covers exposed bone
- Significant depth-fill and contour restoration noted
- Symphony reapplied
- No complications
Week 8
- Robust neodermis covers exposed bone
- Significant depth-fill and contour restoration noted
- No complications
Week 13
- No complications
- 95% epithelialized
Week 17
- No complications
- Healing confirmed
Results may vary. Dr. Alpash K.Patel has a consultancy agreement with Aroa Biosurgery.
Steri-Strips™ is a trademark and property of the respective owner.
