Review Question - QID 215822

A 64-year-old female with a long-standing history of peripheral neuropathy presents for follow-up for a chronic left diabetic foot ulcer. The patient has been treating this with local wound care and one previous debridement by a podiatrist. She is currently wearing a stiff-soled shoe to offload the affected region. A current photograph of the ulcer is depicted in Figure A. She denies any fevers, chills, or purulent drainage from the wound. On examination, bone cannot be probed with a sterile Q-tip. The 2nd ray has hyperextension of the MTP joint with flexion of the DIP and PIP and is passively correctable. What is the most appropriate treatment at this time?