A Case of Complete Epithelialization of an Extensive Foot Wound With Exposed Calcaneus Using Topical Cadexomer Iodine (CIOD) Monotherapy

Managing extensive chronic foot wounds with underlying bone exposure is challenging, particularly in patients who are poor candidates for extensive surgery. Cadexomer iodine (CIOD) is a hydrophilic, sustained-release topical antimicrobial agent that has demonstrated efficacy in reducing bioburden, disrupting biofilms, and promoting autolytic debridement in chronic ulcers. To date, several reports have described epithelialization of small ulcers using CIOD alone, and others have documented epithelialization of larger ulcers when CIOD was combined with surgical procedures. However, no reports of complete epithelialization of large debrided wounds exposing bone with CIOD alone have been published. Herein, we report a case of complete epithelialization of a large debrided wound achieved with topical CIOD. This case highlights the potential utility of CIOD monotherapy for limb preservation through its sustained antimicrobial activity, inhibition of biofilm formation, control of exudate, and facilitation of autolytic debridement in high-risk patients.