Multidisciplinary treatment of a complicated crural degloving injury in a diabetic patient

Abstract

Diabetes is a common disease that potentially interferes with healing processes after lower limb trauma. In our presented case a trimalleolar ankle fracture with undiscovered serious soft-tissue injuries resulted in chronic soft-tissue complications in a diabetic patient, requiring three and a half months of hospitalization in a higher level center and the application of state-of-the-art wound treatment, including vacuum-assisted closure therapy, Integra bioengineered skin substitute, split-thickness skin-grafting, and methods enhancing wound healing, such as polarized light therapy and transdermal CO₂ delivery. The presented case emphasizes the importance of soft-tissue care and multidisciplinary approach in diabetic trauma patients with poor compliance.

Keywords: Amputation; Insulin dependent diabetes mellitus; Mixed bacterial infection.