Surgical excision and closure of a diabetic plantar ulceration
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A 56-year-old male was referred for treatment of an ulcer to the left plantar 3rd metatarsal head. The patient was a non-smoker and had a 2-year history of Type 2 diabetes mellitus with a good control (HbA1c 54 mmol/mol), low-level heart failure, chronic kidney disease and considerable diabetic retinopathy. The patient's regular treatment included Novomix 30, Furosemide, Lercanidipine, Pisinopril, Atorvastatin, Brinzolamide and Timolol eyedrops. He had palpable monophasic pulses and peripheral neuropathy (absent response to a 10g monofilament). He had previously had angioplasty to both legs.