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As part of his job with the Department of Public Works in Gloucester, Richard Kelley is involved in landscaping, construction and general maintenance projects at parks and playgrounds across the city. Being mobile and physically able are central to his livelihood.

So when he learned that a serious infection had developed in his left foot after bunion surgery last January, Kelley says he “went into a tailspin.”

“I was terrified that I was going to lose my foot,” says the 52-year-old Gloucester resident and father of three. “After several weeks, the wound from my surgery wasn’t healing properly and an infection started spreading up my leg. It was sore, raw and looking pretty grim; I didn’t think I’d ever work or walk normally again.”

Diagnosed with type 2 diabetes in 2008, Kelley knew from personal experience that even minor cuts and scratches could be slow to heal and quick to get infected—complications that are commonly associated with the disease. This wound, however, was unlike anything he had ever experienced in the past.

To assess and accelerate the healing process, Kelley’s podiatric surgeon referred him to the Advanced Wound Center at NSMC Salem Hospital. There he met medical director James Balcom, M.D., who prescribed an immediate course of action.

“Richard had been treated appropriately by his podiatrist after his surgery, but his diabetes set him up for a serious limb-threatening infection,” says Dr. Balcom. “We care for a lot of diabetic patients in the Advanced Wound Center who have hard-to-treat wounds, but this was definitely an extreme case.”
To address Kelley’s wound, Dr. Balcom and his team took an aggressive approach that included intravenous antibiotics, tests to ensure that blood was adequately flowing to the foot, regular wound cleaning and Hyperbaric Oxygen Therapy (HBOT).

HBOT is a noninvasive procedure that enables patients to breathe 100 percent oxygen while enclosed in a specially designed chamber at pressures up to three times that exerted by the normal atmosphere. Hyperbaric Oxygen Therapy saturates the patient’s circulatory system with oxygen enabling more oxygen-rich blood to reach the tissues. This helps fight bacteria and stimulate the healing process.

The HBOT proved very successful in jump-starting the healing process. “I had more than 40 daily treatments in the hyperbaric oxygen chamber—each lasting about two hours,” says Kelley. “In just over a week, I started to see results.”

Because Kelley’s infection had progressed so quickly, he required two toes to be surgically removed as part of his treatment. He is thankful that the rest of his foot was salvaged, however.

“It was a long haul, but I couldn’t be more grateful for the care I received in the Wound Center,” says Kelley. “The staff was always kind and reassuring. I’m now back to work and my normal life.”