Review Question - QID 218731

A 47-year-old female with uncontrolled diabetes mellitus and a most recent HgbA1C of 9.9% presents with the foot wound shown in Figure A. She had previously undergone multiple rounds of total contact casting with local wound care for three months at a time, but her wound continued to grow in size and has now progressed to include gangrenous transformation of her third toe. On exam, she has active dorsiflexion of the ankle of less than neutral that does not improve on Silverskiold testing. Which of the following treatment methods, if initiated early in her course of care, could have possibly prevented her diabetic ulceration from progressing to its current state?