Ectopia cordis with multiple ventricular septal defect and sternal cleft in a newborn: a case report

Ectopia cordis is a rare type of malformation where the heart is not located normally. It may be partially or completely located outside the thoracic cavity and can be associated with other congenital abnormalities.

Case presentation

This case report is of a 34-week- and 6-day-old female fetus with a birth weight of 2040 g, a height of 41 cm, and a head circumference of 32 cm. The initial physical examination revealed a responsive newborn with an externalized heart outside the chest, with pericardium protection. In addition, a thoracic wall defect was detected suggesting incomplete formation of the septum bone. Moreover, in this case, the echocardiography report showed a multiple ventricular septal defect.

Conclusion

The management of ectopia cordis is a challenge for any obstetrician and pediatric surgeon due to its rarity. It causes mental agony and anxiety to the parents. With an early diagnosis, termination of pregnancy can be one of the options. Once it is diagnosed late, it needs a multidisciplinary approach, and the services of a very experienced pediatric surgeon to improve the prognosis.

Healing refractory diabetic foot ulcers (DFUs) by ozone therapy and silver dressing: A case report

INTRODUCTION AND IMPORTANCE

Refractory diabetic foot ulcers (DFUs) are still a major health problem and can lead to death.

CASE PRESENTATION

The present case reports a 45-year-old man with an 8-year history of type 2 diabetes who has had left refractory DFU for a year on the left heel with a size of 6 × 3 × 1 cm. The patient's ulcers were infected with Staphylococcus aureus. Despite the routine DFU care (normal saline dressing twice a day and intravenous antibiotic therapy), the patient did not recover from DFU using standard methods. The patient was referred to our wound management team. In the first step, the necrotic tissues of his foot ulcer were irrigated and debrided using mechanical debridement and saline. Next, the patient underwent a 70 μg/dL dose of ozone therapy over a 30-day period in 10 sessions (one 20-minute session every 3 days). Between each session, the patient's wound was wrapped in silver-containing gauze bandages. After two months, the patient's DFUs healed, and he was discharged from our service in good condition.

CLINICAL DISCUSSION

DFU can lead to infection, amputation, and even patient death. Therefore, effective treatment methods are very important for managing DFUs.

CONCLUSION

This case report study was shown that the ozone therapy is an effective approach to improve the healing of refractory DFUs and prevent foot amputation. Therefore, wound-care teams can utilize it as an adjunct to the standard methods of DFU treatment.

Large wound surgery of diabetic foot ulcer with Split-thickness skin graft (STSG), and maggot debridement therapy (MDT): A case report

INTRODUCTION AND IMPORTANCE

Diabetic foot ulcers (DFUs) as one of the complications of diabetes mellitus (DM) can lead to death.

CASE PRESENTATION

The present case reports a 56-year-old woman with an 11-year history of type 2 diabetes who has had left DFUs for two years. The patient had antibiotic-resistant DFUs her left foot, which were completely gangrenous and a superficial ulcer up and under her left foot. Despite the routine DFU care, the patient did not recover from DFU using standard methods. The patient was referred to our wound management team. DFU was treated and managed using split-thickness skin graft (STSG) and surgical debridement, maggot debridement therapy (MDT). After two months, the patient's DFUs healed, and he was discharged from our service in good condition.

CLINICAL DISCUSSION

DFU can lead to infection, amputation, and even patient death. Therefore, effective treatment methods are very important for managing DFUs.

CONCLUSION

This case report study was shown that the combined use of STSG, surgical debridement, and MDT is a safe and effective approach to improve the healing of DFUs and prevent foot amputation.