Optimal Wound Care Saves Suffern, New York, Woman’s Foot

June 11, 2021

It seemed like such a little thing at the time. In 2019, Lizanne Fiorentino of Suffern, New York, was visiting a dermatologist for her psoriasis. The doctor noticed a lesion on her left ankle.

He took a biopsy, which was inconclusive, so he took a larger one. Lizanne was diagnosed with polyarteritis nodosa (an inflammation of the blood vessels), which developed into pyoderma gangrenosum (a rare skin condition that causes painful ulcers). When the stitches for the biopsy came out, the wound had not healed and was open.

Her rheumatologist, Steven Rosner, M.D., recommended getting evaluated at the Wound Care Center at Pascack Valley Medical Center. Lizanne made an appointment, but her condition deteriorated so quickly that on June 3, 2019, she went to the emergency room at Pascack Valley and was admitted there. Within hours, Richard Goldstein, DPM, FACFAS, a podiatrist and podiatric surgeon at the Wound Care Center, was examining her wound. Lizanne remembers him telling her that her condition was so bad that she was in danger of losing her foot. 

The next morning, Dr. Goldstein performed surgery. “There was so much infection that if it got to the joint, I may not have been able to save the foot,” he says.

Tough Road Ahead

In surgery, Dr. Goldstein opened and drained the infected fluids, and removed the toxic and dead tissue. To give the surgical site its best chance to heal well and quickly, he bandaged it using a negative-pressure wound vacuum. With this technique, the wound is packed with sponge-style dressing and covered with a membrane. Fluids naturally drain from the wound through the sponge, and the vacuum helps pull the edges of the wound closed and increase blood circulation to encourage healing.

Five days after surgery, Lizanne was discharged with a portable version of the vacuum attached to her ankle, which she nicknamed “Wilma the Wound Vac.” Even with the device, her surgical site needed to have the bandages changed three times a week. She would go to Dr. Goldstein’s office, where they would remove the soiled bandages, clean and trim the wound, apply medications, and reapply the bandages and vacuum.

The original damage was so severe that Lizanne required skin grafts in July and August to close the wound completely and was on crutches for eight weeks.

The treatments were painful. Lizanne comforted and inspired herself with a personal goal. Her son, Matthew, was planning a wedding in September. She had every intention of walking down the aisle of the church—but not just walking, walking in 3-inch heels.

Lizanne made sure everyone treating her knew her goal and how important it was to her. “It was all she wanted,” Dr. Goldstein says. “She had endured an incredible amount of pain over the months, and I was committed to making her goal happen.”

Goal Achieved

“Wilma” was retired at the end of August, but Lizanne was still under Dr. Goldstein’s care when September 7 rolled around. A thrilled Lizanne walked proudly down the aisle at Matthew’s wedding in those 3-inch heels, even though the skin at her wound was still healing. She was even able to dance at the reception by wearing flats.

When Lizanne’s dermatologist first noticed the small lesion, it hardly seemed worthwhile. Now she advises others, if anything looks strange, get it checked “Funny little things can turn out to be something,” she says.

While she could have lost her foot and lower leg, she is now back on both feet. “I can’t say enough good things about every contact of care that I had from the minute I walked into the emergency room until the day of the wedding,” Lizanne says. “They made such a horrific experience so much more bearable.”

Adds Dr. Goldstein: “Lizanne had a will to heal and complied with the instructions that are a huge part of wound care. It was hard work, but gratifying.”

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