Application in a Wagner 2 Diabetic Foot Ulcer (DFU)
Laura Swoboda, DNP, APNP, FNP-BC, CWOCN-AP
Wound Care Coordinator – Froedtert & Medical College of Wisconsin, Menomonee Falls, WI
Initial Presentation
Week 15 – Healed
Results
- Fully re-epithelialized by week 15
- No complications
- Able to ambulate in diabetic shoe with proper offloading
- No recurrence as of 11-months
Patient details
77-year-old male
Medical history
Uncontrolled diabetes
Case details
- Wound: Full-thickness Wagner 2 DFU of the right foot, sub-metatarsal 1, present for at least 2-months
- Measurement: 2.8 x 2.2 x 0.5 cm
- No insurance coverage for CTP/skin sub/CAMP, nor ultrasonic debridement
Application photos
Initial Presentation
Week 0 - Initial Presentation
- Increase protein intake to 150 g per day
- Continue vitamin D supplementation
- Discussed dipeptide collagen supplementation (30 mL 3-4 times per day) to increase skin moisture, elasticity
- Unable to continue total contact cast (TCC) due to safety concerns
- Modified CAM boot with orthotist consultation and instructed patient to be NWB to right foot
- Plan: Begin weekly application of Endoform Natural
Week 3
- Significant reduction in wound area noted
- Continue weekly application of Endoform Natural
Week 5
- Further neo-epithelialization noted
- Continue weekly application of Endoform Natural
Week 12
- Further depth fill noted
- Continue weekly application of Endoform Natural
Week 15
- 100% epithelialized
- No complications
- Able to ambulate in diabetic shoe with proper offloading
- No recurrence as of 11-months
Results may vary. Dr. Laura Swoboda has a consultancy agreement with Aroa Biosurgery Limited.