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Great Toe Amputation

How do you get rid of a recurring Pyogenic Granuloma that has caused Osteomylitis and amputation of a big toe?

Skin grafts have been attempted as has numerous excisions. Osteomylitis of the bones in the great toe resulted in amputation of the toe.
Wound flap failed and wound has taken 4 months to heal, now is beginning to over granulate again.
No history of diabetes or any other such.

Have you tried a polyurethane foam dressing?

Harris and Rolstad report the findings of a small clinical trial of a polyurethane foam to treat over granulation:
“Although there is very little in the literature regarding hypergranulation tissue, the fact that there are numerous treatments by various wound clinicians demonstrates the recognition of its presence as a clinical problem. The paucity of published information prompted the authors to design a study to collect objective data on a treatment method they had found useful in their practices. This article explores the issue of hypergranulation and offers a nontraumatic method of management. A prospective non-controlled correlational study was undertaken with ten patients and twelve wounds using a polyurethane foam dressing to reduce hypergranulation tissue. The results demonstrated a significant decrease in height of 2 mm of granulation tissue from initial measurements to measurements taken two weeks later."

toe on the loose

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