Friday, March 28, 2008


Pictures are from first to latest. Scroll down to watch the progression.

This is a picture of Victoria's foot on 3/15, about 10 days before we headed to the ER. The black in the right center is a large scab. The pink around the edge is good tissue trying to grow and heal. The area around 10 o'clock is where the tissue got soft (the internal infection started).

This is 4/4. The 'thing' inside around 8 o'clock is the heel bone. Yes, it is very exposed. Most of the yellowish tissue is dead and was removed today by the debrieding machine and WN's work. If you want to figure the damage, the wound is about 4" in diameter and about 1.5" deep, roughly 19 cubic inches of tissue is gone. This is 6 times larger than her previous ulcer and of course, the bone is fully exposed here.

This is the heel on 4/14. The notch at about 11 o'clock is where the width is measured. The black around the outside is 'scab'. Dead surface tissue. The very red ring is area of new tissue growth. Most of the yellowish tissue inside the wound was removed by debrieding.

This is 4/21. The notch at 11 o'clock has all but been filled in. The darkness in the wound at 7 o'clock is leftover ointment that is used to promote tissue growth. You can see there is considerably less yellowish tissue inside the wound. WN removed a lot of the dark dead tissue from around the wound after this picture was taken. If you look at the wound on 4/4 and see the dark rim near 1 o'clock, you can see the change in where the opening is in comparison. There is almost 1/4" of good, healthy tissue between the current opening and the edge of that dark rim.

Latest look, 4/28. This is AFTER the cleaning with the ultrasonic debrieder. There is a noticeable 'lip' on the wound at this point (the skin on the surface is closing faster than the tissue is filling in. Although the overall size has changed only slightly, the depth is considerably improved; it is 1.9cm deep (2.4 was the previous reading). If it looks cleaner to you, it is. Both the internal and external surfaces are getting to be JUST healthy tissue. The 'bloodiness' is a good sign that the tissue is growing and blood flow (a crucial issue) is growing with it. Also, notice the shape has changed from mostly round, to oval.

This is on May 9th right after the cast was removed. The tissue looks good, the orange at the bottom is drainage. That hole is the only deep spot still remaining, but it give access to the bone.

Also on 5/9, this is after cleaning and debrieding. the purpose of this is to show that the tissue has good profusion - the tissue has blood flow. It makes it healthy.

This is 5/14. The tissue continues to grow, but the hole at the bottom is persisting. This place will be the most difficult to close. After debrieding this, the tissue looked similar to the photo above, but the wound looks smaller - it is marginally.

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