“As a practicing rehabilitation physician in skilled nursing facilities and rehabilitation hospitals, I would provide orientation to new physical therapists and nurses to prevent pressure injuries to the heel. I would order arterial studies for patients admitted with heel sores, and proceed from there,” states Greg Vigna, MD, JD, national malpractice attorney and wound care expert.
Dr. Greg Vigna, wound care expert and national decubitus ulcer attorney states, “Stage IV heel bedsores sores are a significant health care burden and are very difficult to treat. These may result in lower extremity amputations related to osteomyelitis. These are caused by broken hospitals and nursing homes that provide inadequate bedside care and unsupervised rehabilitation. Diabetics with vascular disease are the patients most at risk, but can occur in all dependent patient groups.”
Dr. Vigna adds, “Age is not an exclusion criterion for limb salvage, as partial calcanectomy is an option after vascular supply is optimized. The literature describes the standard of care for the management of Stage IV heel decubitus ulcers with or without osteomyelitis:”
“A recent systemic review concluded that a partial or total calanectomy for the treatment of calcaneal osteomyelitis is a viable and durable limb salvage option in the ambulatory patient … 80% of the patients were able to ambulate in regular or custom shoes without the aid of an orthopedic device … treatment of osteomyelitis includes either antibiotics or surgical resection or both,” says Dr. Latricia Allen, Podiatrist.
Click here to read Dr. Allen’s article “Treatment of a High-Risk Diabetic Patient with Peripheral Vascular Disease and Osteomyelitis” published in Techniques in Vascular and Interventional Radiology, Volume 19, Issue 2, June 2016, pages 96-100.
Dr. Vigna states, “Prevention of bedsores is paramount. When a heel pressure ulcer occurs, vascular evaluation is crucial as surgical debridement is futile in the presence of vascular disease and can lead to amputation. Patients with serious heel decubitus ulcers should be evaluated by physicians skilled in skin grafting, and partial and complete calcanectomies after vascular status has been optimized. Other diagnostic testing includes an MRI of the foot to rule out osteomyelitis.”
Dr. Vigna concludes, “We represent the injured who have suffered heel decubitus ulcers across the country, including those who require IV antibiotics, debridement, vascular intervention, partial calcanectomies, and/or amputation. These are serious injuries that can be prevented with adequate bedside care, supervised rehabilitation, and timely treatment, as described by Dr. Allen.”
Greg Vigna, MD, JD, is a national malpractice attorney and an expert in wound care. He is available for legal consultation for families and patients who have suffered decubitus ulcers due to poor nursing care at hospitals, nursing homes, or assisted living facilities. The Vigna Law Group, along with Ben C. Martin, Esq., of the Martin Law Group, a Dallas Texas national pharmaceutical injury law firm, jointly prosecute hospital and nursing home neglect cases that result in bedsores nationwide.
Case Number: CL24000809-00
Mecklenburg County, Virginia
