This patient has DMT2, peripheral neuropathy, an absent post | Figure 1

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This patient has DMT2, peripheral neuropathy, an absent posterior tibial pulse, and a 15 month history of an ulcer and osteomyelitis on the 1st metatarsal head. The patient refuses to attend a specialist wound clinic or hospital. Picture 1 is before debridement (note the necrosis where the wound is tracking to the toe webspace), picture 2 is after debridement. I am curious about the wound surface circled in yellow - it feels spongy and looks like there are many prominent capillaries.

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