Managing a Diabetic Wound with Midfoot Charcot Reconstruction: A Case Study of Acellular Skin Graft Utilization with Circular Frame

Introduction: Diabetic wounds complicated by midfoot Charcot reconstruction present challenges in treatment, often necessitating innovative approaches for successful outcomes. Utilizing acellular skin grafts in conjunction with circular frames offers a promising solution in such cases.  Methods: We present the case of a 62-year-old male with past medical history significant for uncontrolled diabetes, IVDA and Charcot deformity with a non-healing diabetic plantar foot wound. Patient underwent surgical intervention with TAL, midfoot osteotomy, application of circular external fixator and wound debridement with application of acellular fish skin graft.   Results: Complete wound closure was obtained in 16 days postoperatively which allowed for a staged reconstruction. Following closure, the patient underwent removal of circular frame with midfoot arthrodesis which resulted in a plantigrade foot without re-ulceration.   Discussion: Acellular fragmented skin grafts can be utilized alongside circular frames as an effective strategy for managing diabetic wounds during Charcot reconstruction.  Acellular skin grafts utilized alongside circular frames offer an effective strategy for managing diabetic plantar foot wounds during midfoot Charcot reconstruction.   References: