Description of Event or Problem · 0
ON (B)(6) 2020-PT PRESENTS FOR INITIAL WOUND CARE VISIT REGARDING AN ULCER ON HER RIGHT FOOT. IT HAS BEEN PRESENT FOR APPROX 6 WEEKS- SHE DOES NOT KNOW THE CAUSE OF THE SORE. ON (B)(6) 2020- PATIENT NON-COMPLIANT WITH NOT BEARING WEIGHT. FAMILY IS "MILKING" ULCER. PRIMATRIX GRAFT #1 PLACED. GRAFT LOT#: 1912024 ON (B)(6) 2020- PT HERE FOR FOLLOW UP OF RIGHT MEDIAL / PLANTAR FOOT ULCER HER ORIGINAL WOUND MEASURES FAIRLY STABLE TO MARGINALLY INCREASED TODAY- THE SMALL OPENING MORE PROXIMAL ON THE MEDIAL HEEL HAS RESOLVED. GRAFT #2 PLACED. GRAFT LOT#: 2003022 NO NEW INFLAMMATORY/INFECTION SIGNS DOCUMENTED. ON (B)(6) 2020- WILL USE COLLAGEN THIS WEEK BECAUSE NO GRAFT AVAILABLE. DRAINAGE IS IMPROVED. OPENING MORE POSTERIORLY - MEDIAL HEEL- NO DRAINAGE TODAY- RESOLVED. ON (B)(6) 2020- PT HERE FOR FOLLOW UP OF RIGHT MEDIAL / PLANTAR FOOT ULCER. HER ORIGINAL WOUND MEASURES IMPROVED TODAY. THE SMALL OPENING MORE PROXIMAL ON THE MEDIAL HEEL HAS RESOLVED. SHE HAS BEEN APPROVED FOR PRIMATRIX GRAFT - SHE HAS HAD 2 PRIOR GRAFTS. GRAFT IS AVAIL TODAY SO WE WILL PLACE. WILL PLACE PRIMATRIX # 3 TODAY GRAFT LOT#: 2003022 ON (B)(6) 2020- IT SEEMS TO BE CLOSING IN. DRAINAGE IS IMPROVED. NO GRAFT IS AVAILABLE TODAY SO WE WILL USE COLLAGEN. ON (B)(6) 2021- HER ORIGINAL WOUND MEASURES IMPROVED TODAY. HAS SOME PERIWOUND IRRITATION AND PEELING SKIN MORE PROXIMALLY ON THE ANKLE - WILL USE TRIAMCINOLONE/ ZINC PASTE AT THIS SITE - I HAVE ASKED HER NOT TO SCRATCH OR PICK AT THIS AREA. ON (B)(6) 2021-PT HERE FOR FOLLOW UP OF RIGHT MEDIAL / PLANTAR FOOT ULCER. HER ORIGINAL WOUND MEASURES SL LARGER TODAY. NO GRAFT WAS AVAILABLE LAST WEEK SO WE USED BIOSTEP COLLAGEN = SHE THINKS THIS HAS WORKED AS WELL AS ANYTHING - SO WE WILL CONTINUE FOR NOW. SHE HAS SOME PERIWOUND IRRITATION AND PEELING SKIN MORE PROXIMALLY ON THE ANKLE - WILL USE TRIAMCINOLONE/ ZINC PASTE AT THIS SITE - I HAVE ASKED HER NOT TO SCRATCH OR PICK AT THIS AREA. ON (B)(6) 2021- PT HERE FOR FOLLOW UP OF RIGHT MEDIAL / PLANTAR FOOT ULCER. HER ORIGINAL WOUND MEASURES SL LARGER TODAY. - THE SMALL OPENING MORE PROXIMAL ON THE MEDIAL HEEL HAS RESOLVED. SHE HAS TRANSITIONED TO REGULAR SHOES AND TODAY IS WEARING CROCS - WE DISCUSSED CONSIDERATION OF CUSTOM DIABETIC SHOES WHICH IN THE PAST SHE HAS BEEN OPPOSED TO , HOWEVER RECENTLY SHE AGREED - UNFORTUNATELY SHE IS STILL WEARING THE CROCS AND I CAN SEE AN AREA WHERE SHE SEEMS TO BE GETTING SOME FRICTION- I HAVE ASKED HER AGAIN TO TRY TO AVOID PRESSURE AND FRICTION TO THIS SITE = ADVISED SOFT SOLED SHOES WITH GOOD CUSHION AND STRETCH UNTIL SHE GETS HER CUSTOM DIABETIC SHOES. RECENTLY NO GRAFT HAS BEEN AVAILABLE SO WE HAVE BEEN USING BIOSTEP COLLAGEN = LAST WEEK CHANGED TO MEDIHONEY = I WANT TO TRY STIMULEN COLLAGEN POWDER THIS WEEK-WE WILL ORDER FOR HER. SHE HAS SOME PERIWOUND IRRITATION AND PEELING SKIN MORE PROXIMALLY ON THE ANKLE - - I HAVE ASKED HER NOT TO SCRATCH OR PICK AT THIS AREA. SHE HAS AQUAPHOR SHE WILL USE TO THIS SITE. ON (B)(6) 2021- WOUND MEASURES SL IMPROVED TODAY RECALL OF PRIMATRIX ON 05/2023. REFERENCE REPORTS: #MW5148662, #MW5148664.