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Case Series/Study

(CS-079) Use of a Borate-Based Bioactive Glass Fiber Matrix as an Adjunct for Adequate Limb Salvage: Case Study

Friday, April 10, 2026
Joe Spampinato, DPM – DPM
Introduction: Diabetic Foot Ulcers (DFUs) continue to burden the healthcare system with high amputation and mortality rates.1 The purpose of this case was to highlight adequate limb salvage in a medically complex patient with a large infected DFU that tracked from the dorsal to plantar surface of the lateral right foot.

Methods:

A 61-year-old male presented to the emergency department for complaints of cellulites with multiple DFUs, one on the lateral aspect of the dorsal mid foot and the second on the plantar surface below the second digit. The patient underwent right foot incision and drainage (I&D) of the deep space abscesses and debridement of nonviable tissue with washout. The likelihood of limb salvage was uncertain as the patient remained at high risk for a below-the-knee amputation (BKA) due to the severity of infection. A borate-based bioactive glass fiber matrix (BBGFM) was applied as an adjunctive treatment to achieve adequate limb salvage.

Results:

After undergoing an initial I&D, cortical erosive changes were evident suggestive of osteomyelitis. Consent was obtained for a second I&D procedure with wide debridement and partial 2nd ray amputation of the right foot. On post operative day (POD)-three the BBGFM was applied along with vacuum assisted closure (VAC). The open surgical sites of the right midfoot and right lateral malleolus remained stable with discontinuation of the wound VAC on POD-five. With the surrounding erythema and edema resolved, as well as the wound base largely appearing fibrogranular, the patient was discharged on POD-6.

Discussion:

This complex case highlights the use of a BBGFM alongside various treatment modalities in a large Wagner Grade III DFU, leading to adequate limb salvage and timely hospital discharge. These findings support the use of the BBGFM as part of a multimodal wound care strategy in challenging wounds.