The Wound Whisperer
Transdermal Oxygen for an Ischemic Achilles - My Secret is that it WORKED

A dermatologist froze a lesion on the posterior calf of a woman in her 80s. About two weeks later, a wound spontaneously opened distal to the site of the procedure that exposed her Achilles tendon (Image1).

Image 1

She was told she had no peripheral arterial disease, and she certainly had strongly palpable dorsalis pedis and posterior tibial pulses. However, whenever an ulcer spontaneously opens to expose a tendon, we have to assume it’s due to ischemia until proven otherwise. She needed an angiogram so I sent her to the best endovascular expert I know.

The angiogram showed she was, in fact, free of peripheral arterial disease – except that the Achilles branch of the peroneal artery was MISSING, presumably the victim of the previous cryosurgical procedure. Angioplasty can’t restore flow to a vessel that is missing. Somehow the posterior tibial artery had to be encouraged to make collateral vessels to granulate the exposed tendon.

A few days earlier I had received samples of the OxyBand dressing which can provide transdermal oxygen to a wound for three or four days after an application. I didn’t believe it could or would work, but I didn’t have a better idea and it was certainly risk free (Image 8 and Image 9).

Image 8


Image 9

See for yourself what transdermal oxygen did for this woman’s exposed Achilles tendon  (Images 2 -7).  You can see the granulation tissue migrate from the medial side where the posterior tibial artery is intact, to the lateral side where the peroneal artery supply is missing. In fact, in the second photo you can imagine the dividing line between these two vessels that supply the Achilles. I appreciate the OxyBand Company which donated dressings for eight weeks until the tendon was completely granulated. Now the wound is epithelializing, we are using the usual suite of wound dressings along with compression bandaging to control edema.

Image 2

Image 3

Image 4

Image 5

Image 6

Image 7