A Case Study on the Combined Use of an Epidermal Autograft and NPWT

This is the account of a patient case in which technology, clinician experience, and patient adherence converged to save a limb.

In August of 2013, a 59 year old female with noninsulin-dependent diabetes mellitus, severe peripheral artery disease, a history of tobacco abuse and a recent right transmetatarsal amputation (TMA) was referred to our hospital-based outpatient department by her home health nurse. Her surgery was one month prior to presentation. During her intake visit with the foot and ankle surgeon, she recounted her post-surgical instructions to include "wash incision once daily with betadine." The home health nurse had referred her back to the surgeon's office with concerns that the surgical incision was not approximating beneath the staples and wound closure strips. At that time, the surgeon removed all closure devices, leaving the wound open. He did not change the patient's care regimen.