Diabetic foot ulcer healing with polylactic acid membrane assessed by thermographic imaging: a case report

Abstract

Diabetic foot ulcers reduce patient's quality of life and increase treatment costs, evaluating this condition is promising. We report the clinical progression of an elderly patient who developed a diabetic foot ulcer following minor trauma. She was treated for over 2 months until her condition progressed to Grade 4 on the Wagner Classification of Diabetic Foot. A Serial infrared thermography was performed. The treatment plan included antibiotics and a polylactic acid membrane until complete ulcer remission. Thermographic imaging showed a quantitative reduction of the temperature differences between the affected and contralateral foot from an initial ΔT: -4.6°C ± 2.4, progressing to ΔT: -1.7°C ± 1.6 at 12 weeks, and a temperature reduction from the proximal third tibial area with ΔT: -1.7°C ± 0.6, with a change to ΔT 0.8°C ± 0.4 at 12 weeks near the metatarsal bone region. This article underscores the use of infrared thermography to give physicians feedback on ulcer healing progression phases and treatment effectiveness.

Keywords: diabetes mellitus; diabetic foot; infrared thermography; polylactic acid membrane; ulcer healing.

FIGURE 1

Clinical photographs of the ulcer remission from left to right at the initial consultation (A), at 3 weeks (B), 9 weeks (C), and 12 weeks (D).

FIGURE 2

Use of thermography for ulcer remission assessment. Frontal areas with the lowest temperature are displayed in blue and the highest temperature in white. Change progressions are depicted until similar views were obtained after the wound complete healing, from left to right, at the initial consultation (A), at 3 weeks (B), 6 weeks (C), 9 weeks (D), and 12 weeks (E).

FIGURE 3

Change in the ΔT values through time between the toes in the affected limb and the contralateral limb (black). Change of zone length of the affected limb with the biggest ΔT values in comparison with the contralateral limb (red).