HBO for eschar at BKA site

Patient with type 2 DM required a BKA with a history of Wagner 4 DFU prior. Developed eschar at the amputation site and was sent to vascular surgery, with further revascularization attempts made. He is sent to us for HBO. Could he be given the diagnosis of Wagner grade 4 for HBO treatment post amputation. If not, could he qualify under compromised flap. He has Medicare insurance. Appreciate the input.

Nov 15, 2024 by Bill Khoury,

1 replies

Craig Lindsey
MD

Thanks for your question Bill,

The Wagner system was developed and is used commonly for classification of diabetic foot ulcers. The case which you describe, although started as a DFU and was categorized as a Wagner grade 4, was in essence resolved by the BKA surgery. The eschar now associated with the surgery site would be best now described as a failing or compromised flap, and as such, will qualify for HBO via medicare guidelines.

Hope this helps

Craig Lindsey, MD

Nov 15, 2024

* Information provided without clinical evaluation and is not intended as a replacement for in-person consultation with a medical professional. The information provided through Curbside Consult is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.

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