Healing a bear of a wound

Brett Wagner, 48, first visited Methodist Hospital wound care after he tore open a callous under the little toe on his right foot. Doctors treated a recurring staph infection in the wound, and were able to finally close the wound using a surgical procedure called metatarsal shaving. A short time later, another wound appeared under his second toe.

It wasn’t until a battery of tests was completed that Wagner learned he had type 2 diabetes, which was why his foot wounds were so difficult to treat. “Those with diabetes get neuropathy, which makes their feet numb, and prone to hammer toes and the loss of padding underneath their feet,” Wagner says. “This causes the toe joint to poke down during activity, causing a lot of pressure on one point of the bottom of the foot.”

Together, recurring wounds and type 2 diabetes were creating a difficult cycle for Wagner. “I needed to exercise to lose weight and help improve my diabetes, but I couldn’t because of my wounds,” says Wagner, who was moderately active before developing his foot wounds.

Wound treatment is trial and error process
Thankfully, Methodist Hospital wound care staff was able to step in. By working with a care team, including a primary care doctor, podiatrist, orthotist and wound care physical therapist, Wagner began to heal. He was guided through several procedures, including surgical debridement, surgical metatarsal shaving, shoe orthotics, pulsed lavage and infrared techniques. During surgical debridement, doctors open the wound and remove all infected areas. Metatarsal shaving is a procedure where the metatarsal head is shaved down so it no longer applies pressure on the wound area. Shoe orthotics are designed and adjusted by an orthotist to distribute and offload the weight over the wound area. Pulsed lavage cleans the wound using a low-pressure water spray. Infrared uses laser infrared light that is absorbed into cells to increase their activity and improve blood flow to the area.

Total contact casting has been the most successful treatment for Wagner. Through this treatment, his foot is put in a knee-high fiberglass cast that pads his foot and relieves some pressure on the wound. The cast is removed each week, and if the wound is not yet healed, the cast is reapplied. “It usually takes two to three weeks in casts for my foot to heal,” Wagner says.

Although Wagner still is recovering, he is optimistic about the future. “I’m still dealing with one wound under my foot, but our hope is that we will be able to get it healed by casting, and keep it healed with orthotics,” he says.

Team approach aids care, recovery
Wagner is grateful for the care he has received and believes Park Nicollet’s team approach has been instrumental in his recovery. “I think humans are a lot like bears when they get wounded; we get really cranky,” he says. “There are many times I have gone to the wound clinic frustrated and cranky, but after the excellent treatment and encouraging attitude of my therapist, I left smiling. I can’t imagine trying to heal these wounds without the Park Nicollet team, and especially my wound care therapist.”

Park Nicollet Methodist Hospital’s wound care services provide assessment, direct patient care and education for patients with diabetes-related foot and leg ulcers, pressure ulcers, arterial or venous insufficiency wounds, minor burns or trauma, non-healing surgical incisions and more. Call 952-993-5900 to make an appointment.