The Story of Daryl

This is for video : https://youtu.be/GID1NnTr8So

Daryl is a long-time patient who is a Type I diabetic with total neuropathy in his feet.  He had various wounds over the years and had already had the 4th toe and part of the metatarsal amputated. 

He presented at this time with a chronic wound under the big toe joint on the right foot.  Every time we would get it healed, it would open up again within 6 months.  There is a bone right underneath the wound that is putting pressure on the skin from the inside, while the ground presses from the outside.  This causes the skin to break open. 

The Story of Daryl 1
Photo #1

We went to surgery to remove this little sesamoid bone from under the ulcer.   Here is the surgery. (photo #2), and here is the sesamoid bone we took out (photo #3). 

The Story of Daryl 2
Photo #2
The Story of Daryl 3
Photo #3

When he came in for his first post operative appointment, the foot was quite red, swollen and infected.  (photo #4, 5)

The Story of Daryl 4
Photo #4
The Story of Daryl 5
Photo #5

The  soft tissue and the bone had become infected so quickly that the great toe and part of the metatarsal had to be removed.  Due to the infection, the wound was packed open.  (photo #6 and 7).

The Story of Daryl 6
Photo #6
The Story of Daryl 7
Photo #7

As the weeks passed, the skin grew in and the wound closed, and soon he was on his way with no further wounds.  (photos # 8,9,10)

The Story of Daryl 8
Photo #8
The Story of Daryl 9
Photo #9
The Story of Daryl 10
Photo #10