HELP - Foot Ulcers Won't Heal
My wife suffers from ulcers on top of both feet and has tried all treatments prescribed by various physicians. Unfortunately, the ulcers will not heal. Any help would be appreciated.
Background: 44 year old caucasian female. 5'3", 210 lbs. My wife is NOT diabetic. Suffers from full body rheumatoid arthritis (14 years), edema in both legs, Charcot foot syndrome in both feet (not operable until ulcers are healed) and has 3 partially fractured/compacted lumbar vertebrae (operation deemed not necessary at this time), She survived septic shock in Sept 2007, unknown cause. The only repercussion of the septic shock was that she developed a large/deep open wound (popped blister) on the entire back side of her right calve. This healed down to a 2cm x 2cm wound within 1-2 months and took over 1 year for the rest to heal shut. She had varicose vein ablation in both legs to eliminate varicose veins and to reduce edema. The edema in her left leg is almost gone. The edema in her right leg continues to be a problem, but is far less severe than prior to the vein ablation. She has had 3 femur repair surgeries in 2007/2008 to her left leg (femur broke, rod broke, femur broke above the 2nd rod). She had one large ulcer and several small ulcers on top of her left foot, but since the vein ablation procedure, they have for the most part healed and now she only has 1-2 small ulcers left on top of her left foot. She has one large ulcer on top of her right foot and several small ulcers on her toes and sides of her foot. The toe next to her large to is broken, but will not be set until the ulcers are healed.
Description: The ulcers are surface ulcers (not deep). They are covered by a pale yellow covering (granulation tissue ?). The ulcers vary in size. Large ulcers are approx. 3cm x 2 cm. Small ulcers are approx 0.5cm x 0.5cm. The ulcers started as small red spots and developed into ulcers. She has patches of skin on her feet appears slightly red and has a cream color marbling. The ulcers were diagnosed as Pyoderma Gangrenosum, Neuropathic Ulcers and Venous Stasis Ulcers. Most of the physicians that she has seen feel that they are Venous Stasis Ulcers. The ulcers are extremely painful. I would gladly post pictures of the ulcers, if this message board supports it, and will email pictures to serious responses, if requested.
Current Treatment: Lidocaine Jelly to relieve some pain, Silver Sulfadiazine Cream on the affected area, covered with telfa, wrapped with an ace bandage/pressure dressing. She elevates her legs/feet as much as possible and frequently applies ice packs to relieve some pain.
Previous Treatments: My wife has been seen by a variety of specialists for her ulcers (wound care center, infections disease specialist, 3 podiatrists, dermatologist, vein specialist and her primary care physician (Internal Medicine)) She has tried a wide variety of creams/ointments/dressings, the ulcers were debrieded and has used debriedment cream on the ulcers, coban wraps and other wraps have been applied, she tried Dermawound (alternative treatment), she elevates her feet/legs as often as possible, Until now, the only positive sign was the partial healing of the ulcers on her left foot, after the vein ablation.
We are looking into other treatments available (mostly alternative) such as oxygen therapy, B-12 cream from Germany (Regividerm?), hypobaric chamber, etc.
If you have any valid recommendations, please let us know. Of course, due to the near constant pain, with periods of extreme pain, the lack of healing and her other health issues, depression is becoming another issue. Any valid ideas or help would be GREATLY appreciated.