Abstract

Introduction: Diabetic foot ulcers may determine non-traumatic amputations of the foot, with a high impact on the patient's life. Transmetatarsal amputations (TMA) represent an effective surgical procedure in cases of severe foot infection, but the tissue reconstruction is complicated and additional procedures should be considered. The authors evaluated the wound closure of an open TMA in a diabetic patient treated with a new material registered as waferspongeTM, based on chitosan and chondroitin sulphate nanocomplex, without the need of skin grafting. Case Report: A 72-years-old man with diabetes and a history of successive amputations was admitted to the Valdivia Hospital (Chile) due to a severe infection of foot. After the diagnosis of gangrene and osteomyelitis the patient underwent a TMA on his right forefoot. The surgeon proposed the incorporation of waferspongeTM to accelerate the wound healing and not submit the patient to another surgical procedure. The surgical wound area of 37.87 cm2 closed 50% after 28 days and complete closure was achieved in 94 days of treatment, with high-quality epithelial tissue and good cosmetic results, without residual limb deformities. The procedure was ambulatory with minimal physical and psychological impairment for the patient. Other surgical procedures were not necessary. Conclusions: Limb amputations cause a great emotional impact on diabetic patients, especially if they had undergone a previous amputation. The use