Mr. J.M. from East Africa came to me with post surgical large wound of the right foot. The First metatarsal and second metatarsal bone?s head being exposed and infected. The third toe being gangrenous (totally black) and the surrounding skin with thick gangrenous margin. The third toe totally gangrenous and rest of wound with secondary infection.
I did start with homeopathic medicine Ars. Alb. 1000 3 hourly but the surgery was to be designed to my choice. The decreased vascularisation improved within 48 hours as per Non- Visualising Doppler study.
Normally I hate osteotomy of the head of the metatarsal bone as it promotes osteomyelitis and worsen the patients condition.
Here the picture clearly reveals that the head of the first and second metatarsal bones have become brittle and osteolytic. So both the heads were removed surgically.
A vigil was kept by to see that after the osteotomy the margins of excised bones were filled and were made smooth to ensure no further infection.
Moreover the bones were excised deep under the healthy granulation tissues.
Second Picture : During treatment
Shows that the whole wound was sutured and an attempt was to cover up the maximum part of the wound. At this juncture SULPH. ACID 200 was introduced. Sulph. Acid is a king remedy to hold sutures intact and also keeps the sutures away from getting infected in all cases. Here the patient being diabetic the fear of infection is much more higher but Sulph. Acid will never disappoint. Sulph. Acid prevents the complication of surgical trauma.
As usual the patient was kept on Regular Human Insulin tds. Later step wise the sutures were removed as per the merit of the wound. This picture also shows that rest of the toes have completely recovered from Dry gangrene and the shapes were also maintained
After the complete removal of the sutures the patient was once again put on to Ars. Alb. 1000 three hourly for another 15 days. The X-Ray was advised to rule out any post operative complication of osteomyelitis. Though in the initial stages of diabetic foot the X-Ray is always deceptive, still the precaution was observed.
Third Picture: After treatment
Complete recovery and the patient went back walking on his foot. Ars. Alb. was chosen as the patient had mental disgust, Fear of recovery without suicidal tendency and without thirst.
The other Remedies as per indication are: Sec. Cor., Lacheses, Crotalus Horridus., Carbo Veg., Tarent. Cub., Kreosotum, Antraxinum etc.
For spreading cellulitis: Rhus Tox., Apis M., etc..
For Bleb: Hep. Sulph., Apis etc..
For Callosites: Antimony Crud., Thiosinaminum etc..
Local (Topical) application : Echinacea Mother tincture in 1: 5 dilution with distilled or auto-claved water.
Dr. Prabhakar Shetty L.C.E.H. (Bom.)
(Specialised in Diabetic Foot & Gangrene)
SAI DIABETIC FOOT (GANGRENE) NURSING HOME
1 / Kanti Mahal, Telli Galli, Opp. Hotel Imperial Palace, Andheri (East),
Mumbai – 400 069.
Phone: 91-22 – 2684 2436 / 2684 0255
Time: 11.30 a.m. to 1.30 p.m. & 5.00 p.m. to 7.00 p.m.
Wednesday: 5.00 p.m. to 7.00 p.m. (By Appointment only)
Web Site www.diabeticfootgangrene.com e-mail firstname.lastname@example.org