CLINICAL CASE | Chronic wound in patient with comorbidities
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CLINICAL CASE | Chronic wound in patient with comorbidities in San Diego CA
64-year-old female patient
History of bilateral saphenectomy, hypothyroidism (under treatment), diabetes, and hypertension, all with good metabolic control.
Initial visit:
chronic wound showing signs of infection. Had previously been treated with metronidazole without improvement. On physical exam, infection was confirmed. A
Doppler ultrasound
showed
preserved circulation.
Metronidazole was stopped, and
ceftibuten was started.
Follow-up (12.03.24):
Patient returned consistently and showed good adherence and steady improvement. A skin graft was suggested, but patient declined. Continued with conservative management: Scheduled wound care, advanced dressings, and tight metabolic control.
Progress (01.07.24):
Wound fully closed, in epithelialization phase. Main complaint: Neuropathic pain, resolved with gabapentin adjustment.
Final follow-up (20.12.24)
Discharged and referred to gait rehabilitation with custom footwear adjustment.
Key takeaway:
Not all wounds require surgery. With proper follow-up, patient commitment, and a multidisciplinary approach, even complex wounds can heal conservatively.

