Mr. Valdez, a 45-year-old construction worker and has a 15- year history of insulin-dependent diabetes. One day after he came home from work and took his shoe off, he noticed a blood soaked sock on his left foot. He noticed he had stepped on a rusty nail which had penetrated his foot.
He didn’t have any pain and a few days passed by without any pain. Several days passed and his wife noticed the redness was going up the leg from the bottom of the foot and the 2nd toe was turning black (Fig 1).
When he came to the emergency room, I immediately scheduled him for surgical treatment. His 2nd toe was becoming gangrene which had to be removed and pus that was traveling toward the leg had to be drained. His left foot was treated with something called the Wound Vac (Fig 2) which is used for suctioning of pus within the deep tissues of the foot. He was able to heal the wound but took several months (Fig 3).