Case Study: Avoiding Amputation After Pharmacy Wart Treatment
Meet Hilson
- Plumber for a large construction company
- Loves his job
- A 50-year-old father of two
- Loves dirt biking
Hilson came into our clinic with some reservation and doubt. He’d previously been left frustrated by the mishandling of his painful left foot from other practitioners. Hilson was not adequately referred for treatment and so was forced to take time off work because of the pain. This was costing him and his family much-needed money and was straining his generally positive outlook on life.
The Problem: A Wound on His Left Foot
Hilson had an unresolved wound beneath his left 1st plantar metatarsal head (beneath the ball of the foot at the big toe)
it was caused by the longstanding application of “WartOff” he had been purchasing from the pharmacy, which caused second-degree chemical burns
9 Months of Pain & Amputation Advice
After nine months of being turned away by four practitioners who did not provide any solution to his pain or involve anyone else in his care, Hilson had taken to trying to manage the pain himself.
Eventually, Hilson did receive a referral to an orthopaedic surgeon, who suggested that he should have a partial amputation of the 1st metatarsal head to try to heal the wound. No further investigations were performed and Hilson was prescribed a single course of antibiotics. Hilson decided to not proceed with the amputation.
AFTER SOME RESEARCH, HILSON CAME IN TO SEE US
- A chemical burn that was larger than a 50 cent piece beneath his forefoot
- Red & purple bruising around the area
- Pus-like discharge from within and around the wound
- Fragile, macerated skin surrounding the wound
- Extreme pain on touching the wound site – 9/10 on the pain scale
- Inability to walk and put pressure on the ball of the left foot
- Inability to wear shoes without immense pain
IMMEDIATE ACTION REQUIRED
From our findings, Hilson urgently required:
- Antibiotics to help with the current infection
- X-ray to check for osteomyelitis, septic arthritis, sepsis & infection-induced necrosis – all very severe consequences due to the longevity and severity of Hilson’s infection
Thankfully, each of the reports came back clear for the above. They did find degenerative changes to the big toe joint, which may have stemmed from the wound being neglected.
Podiatrists & Wound Care
Although this is a dermatological case, Podiatrists can play an important role in diagnosing and treating wounds, dermatological conditions, skin concerns, identifying possible skin cancer lesions & help doctors with patient management for all skin, hair and nail concerns – whether diagnosed or not.
Hilson’s Treatment Plan
Hilson needed specific wound care to allow the wound to heal, alleviate his pain and infection, and stop the symptoms from getting worse. We:
- Debrided the dead and infected tissue away from the wound under local anaesthetic to help the wound heal.
- Dressed the wound well with the right antibacterial materials.
- Added padding to greatly reduce pressure directly over the wound.
- Gave Hilson the right dressings and paddings to use at home, and taught him how to best use these.
- Provided Hilson with a medical certificate supplied to excuse him from work for one week due to his inability to wear enclosed shoes.
- Scheduled his review in two days to check and redress the wound, as well as discuss better footwear options that will help him stay more comfortable while his wound heals.
Results!
80% of Hilson’s wound healed by 3 weeks, with complete wound closure by 5 weeks after first consulting us. He was cleared for work after two weeks if wearing protective shoes.
During his recovery, Hilson has had no complications and continued to see us monthly for 3 months after his wound closed. This was to ensure that the integrity of his skin remained intact and that the wound wouldn’t open or break down as he returned to full weight-bearing during work. It didn’t. Because we debrided the dead tissue, Hilson was left with minimal scarring, too.
Hilson was ‘over the moon’ with his results – and so were we. He now continues to do the work he loves, provide for his family, and has full medical clearance to do anything he’d like without restrictions.
