Bruce Successfully Battles Diabetic Foot Wounds

Bruce Bingham, age 65, knows the pain of losing a toe from a wound that won’t heal. He also knows the value of expert wound healing to halt the progression of a wound.

Diagnosed nine years ago with type 2 diabetes, the Lebanon, Ohio, resident is one of more than two million Americans who has a diabetic foot ulcer.

Five years ago, Bruce spent his days on his feet, working in a plant that makes paints and coatings for food packaging. When a blister formed on his right foot, he wasn’t concerned.

“I didn’t think anything about it,” he says. “Eventually, it got worse and worse. I was in a lot of pain.”

During a visit to Bethesda North Hospital’s Emergency Department, Bruce met podiatrist Haim Cohen, DPM, with the TriHealth Orthopedic & Sports Institute, who evaluated Bruce’s foot and made a plan to minimize the damage. Dr. Cohen has saved hundreds – and perhaps thousands – of people’s lower limbs through skillful wound management.

Because infection had set in on Bruce’s foot, Dr. Cohen performed surgery to remove Bruce’s little toe and the infected bone beneath. He then sent Bruce to the TriHealth Advanced Wound Healing Center at Bethesda North Hospital to accelerate healing of the post-surgical wound.

Advanced Wound Care

“You can’t get this level of care in a private office setting,” Dr. Cohen says of the wound center, where he is a member of the medical team. “Our staff is unparalleled.”

He works with a team of vascular surgeons, infectious disease specialists and hospitalists to make a treatment plan that considers all factors contributing to a patient’s healing process.

Bruce’s wound was slow to heal, since the wound had to heal from the inside out.

“For 30 days, I came in for hyperbaric oxygen therapy,” Bruce recounts. With this advanced technology, a patient lies inside a glass tube and breathes 100 percent oxygen. The increased oxygen concentration stimulates formation of new blood vessels to accelerate healing. 

“At first, I didn’t really believe in it,” Bruce admits. “But you could see progress within the first week or two.”

Bruce’s right foot is now completely healed. He has developed a new problem on his left foot, however, due to a deformity in his foot structure that causes him to walk on the outside edge of his foot.

A New Wound to Heal

The new wound also started with a blister that didn’t heal. Bruce quickly made an appointment to see Dr. Cohen.

During Bruce’s weekly visits to the wound center, Dr. Cohen cleans out any infection and debrides dead tissue from the ulcer on the outside of Bruce’s left foot. Additionally, because walking can aggravate and reopen a wound, the wound center uses various techniques to reduce pressure on the foot. These include a football wrap, which is an abundance of wrapped material that looks like a football when finished, or a total contact cast, which locks the ankle in a 90-degree position, controls gait, and redistributes a patient’s weight.

“Offloading with a total contact cast is considered the gold standard for healing a diabetic foot ulcer,” says Todd Quincy, the wound center’s community educator.

After several months, Bruce says his wound is nearly healed. Dr. Cohen has recommended a foot and ankle brace to relieve pressure on Bruce’s outer foot when he walks.

Bruce is grateful to the people who have helped him through his long healing process. “Everybody at the wound center has been great,” he says. “They’re up on the latest things to heal wounds. I’ve built up a good relationship with the nurses, front desk people and Dr. Cohen.”

His wife, Brenda, has tirelessly helped and supported him. “She’s been through a lot to help me get to where I need to be,” he says. “I couldn’t do this without her.”

Dr. Cohen cautions that Bruce’s foot deformity could cause additional problems down the road, but Bruce isn’t taking his eye off the goal of getting back on the golf course and walking along the beach on South Carolina’s Kiawah Island.

The Value of Prompt, Expert Wound Care

“The time it takes a wound to heal is greatly affected by how quickly the wound is treated,” says Community Educator Quincy. “We want to see people within 30 days of a wound developing to prevent infection, provide care and restore quality of life.”

Quincy says foot wounds in people with diabetes can be particularly difficult, because they often develop neuropathy – a loss of sensation – in their feet. He notes that 85 percent of diabetes-related amputations follow a foot ulceration. Half of those with an ulceration on one foot develop a wound on the other foot within 18 months.

With prompt care at the wound centers, Quincy is convinced amputation numbers can be greatly decreased. Treatment options for diabetic foot ulcers at the wound centers include:

• A total contact cast that keeps contact away from the wound
• Debriding, or cutting away dead tissue, to create blood flow to the wound
• Bioengineered skin substitutes to allow the body to regenerate its own skin
• Hyperbaric oxygen therapy

Quincy concludes, “At TriHealth Advanced Wound Healing Centers at Bethesda North and Good Samaritan hospitals, amputation prevention is our mission, and wound healing helps us achieve that.”

For more information, call the Bethesda North Hospital wound center at 513 865 5050 or Good Samaritan wound center at 513 862 5050.

Tips to Take Care of Your Feet

If you have diabetes, our wound healing team recommends the following foot care practices to keep your feet healthy. Community Educator Todd Quincy notes, “The importance of doing this has exponentially increased due to COVID-19.”

• Check your feet daily for red spots, cuts, swelling, blisters, sores or other injuries. Use a hand mirror to help you see the bottoms of your feet.
• Wash your feet every day and dry them with care, especially between the toes.
• Trim your toenails as needed after you’ve washed and dried your feet.
• Use moisturizing lotion if your feet are dry and cracking (but don’t use it between your toes).
• Wear properly fitting shoes that do not rub or pinch your feet.
• Ensure nothing has fallen into your shoes, such as a small toy or earring.
• Always wear socks or stockings with your shoes, and never walk barefoot or while wearing just socks.
• Physical activity can help increase circulation in your feet. Consult your healthcare team to see which physical activity is right for you.
• Take off your socks at your next check-up, and alert your doctor to any problems with your feet.