Elderly lady (type 2 diabetic) with 5 year old diabetic foot ulcer on the heel, covering the entire heel. A wide range of approaches had been taken to facilitate healing, but without luck. The ulcer was associated with considerable pain in the leg. It had for the past long time been in a full cast for off-loading of the heel.The wound was washed with water and dried, Amicapsil was applied and the foot was, as usual, enclosed in a full cast to off-load the heel. The following day, the wound had changed from a dark-red very dull lifeless appearance to a red colour, normal to healing tissue; clear signs of granulation and epithelialisation were present; and the pain level had gone down. This improvement continued the following days; the pain was gone within 3 days of first application and this alone led to a huge increase in the mood of the patient. Four weeks after first application, the ulcer has decreased 55% in surface area. Due to the necessity of the full cast, daily application was only achieved the first 3 days; thereafter and for the remainder of the application period, the dressing and Amicapsil was only changed twice weekly, As the cast prevents effective evaporation and the circulation of air, it likely reduced the speed of progress. At 16 weeks after first application, the wound had closed by 85%.
|Start of application
The graph below plots the surface area of the ulcer as a function of time. The x-axis is logarithmic and a common phenomenon in biology is that changes follow a log-function instead of a linear function. The R-square value is 0.9998, which means that the correlation is very close. The graph shows that the healing of ulcer has proceeded at a constant speed since starting the application of Amicapsil. This means that the ulcer has not suddenly stopped and then a few weeks later started again, but has improved continuously.
The curve itself is unique to this ulcer and reflects the healing process in that specific patient under those specific conditions. Usually the healing process is much faster.