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A Severe Infection Almost Took His Foot. Now One White Plains Hospital Patient is Standing Strong.

White Plains Hospital

July 5, 2023

A Severe Infection Almost Took His Foot. Now One White Plains Hospital Patient is Standing Strong.

When an infection following an operation to correct an arch left Steven Doyley at risk of an amputation, the doctors at White Plains Hospital helped get him back on his feet.

Having flat feet may not seem like a big problem. But when Steven Doyley was diagnosed with the condition as a child, his doctor warned his mother that it could lead to other health problems, including bone spurs and back pain. To head off potential issues, Doyley underwent two corrective surgeries at a local hospital as a teenager. It soon became clear to him, however, that the arch on the right foot didn’t come out as well as his left: “I still felt like there was something wrong with it,” Doyley recalls.

Doyley thought his foot would improve over time, but unfortunately, it only worsened. By the time he was in his late twenties, he was enjoying a career in radiology care coordination at a hospital, but also dealing with constant pain and stiffness in his foot. Determined to get answers, Doyley, a resident of New Hampton, NY in Orange County, consulted with a podiatrist and had an operation at another hospital in early December 2021. Rather than the relief he hoped for, the procedure led to a series of medical complications.

A Stealthy — And Potentially Deadly — Infection

To correct Doyley’s arch, his podiatrist used metal plates and screws to fuse the bones of his right midfoot. Doyley knew from past experience to expect postoperative pain, yet a couple of unanticipated things happened in the days that followed. “I was having a lot of night sweats,” he says. “My cast had a fabric wrap instead of plaster over the top of my foot, and I kept seeing blood on it.” Concerned, he visited his doctor, who said everything looked fine. Doyley returned to his home, where he lives with his brother and mother; however, his conditioned worsened.

Two days later, while using the bathroom, he felt dizzy. “I called out to my brother right before I passed out, and he and my mom called 911,” he recalls. Doyley spent several days at a local hospital, after physicians determined his wound had become infected and that he had developed sepsis. After he was discharged, he went to see an infectious disease specialist recommended by his podiatrist. The news was alarming. “He said I needed to be in a hospital again right away, on I.V. antibiotics,” Doyley remembers.

An Expertly Customized Action Plan

His podiatrist immediately called White Plains Hospital, where he knew world-class experts were on hand to provide the complex care Doyley needed. First, Dr. John Cappa, a White Plains Hospital Podiatrist who sees patients in the Wound Care Center, took Doyley to the operating room where he washed out his wound. Dr. James McWilliam, an Orthopedic Surgeon who specializes in foot and ankle surgery, also examined Doyley.

“He was pretty sick,” Dr. McWilliam recalls. “His infection had started spreading systemically and affecting his blood pressure and [other aspects of his body].” Worse yet, the skin on the top of Doyley’s foot had been eaten away so badly by the infection that the bones beneath it were exposed and infected as well.

Fortunately, White Plains Hospital has a dedicated Limb Preservation team that specializes in cases like Doyley’s. In addition to Dr. McWilliam, the interdisciplinary group includes wound care specialists, vascular and plastic surgeons, and podiatrists. [See “Going Out on a Limb” on page 10.] After conferring, the physicians decided that additional operations were the best course of action. The day after Doyley’s first surgery, Dr. McWilliam performed another, first washing out the foot again, and then removing the plates and screws that held the midfoot bones together. Instead of replacing the hardware, which might have provided a site for bacteria to latch onto, he put a device called an external fixator on Doyley’s foot. It consisted of pins inserted into the foot, connected to a frame of rings and stabilizing bars.

Preventing the Worst Possibility

Doyley still wasn’t out of the woods, however. Since their first meeting, Dr. McWilliam had warned him there was a chance his foot would need to be amputated. “It definitely wasn’t something I wanted to hear, and a lot of emotions came out. After the first operation, when I woke up, I had panic attacks,” Doyley says. But from the start, he shares, White Plains Hospital’s physicians made sure he understood the course of his treatment. “They told me what they wanted to do moving forward to save my foot,” he explains. Because of this, he knew to expect yet another operation after the first two.

Before that could happen, however, a complication arose. During the period between his second and third surgeries, Doyley contracted COVID. He spent days in an isolation room, unable to see his family. “I was FaceTiming everyone, just trying to keep in touch,” he says. “But the Hospital staff was great. There were doctors and nurses making visits, and they answered all of my and my family’s questions.”

When he recovered from COVID, his third and final operation was performed by Dr. Chris Devulapalli, a plastic surgeon who has special training in vascularized tissue transfer techniques, who covered the open wound on Doyley’s foot using tissue removed from his thigh. “It was more than a skin graft,” Dr. McWilliam explains. “You can’t just put skin on top of exposed bone, because it’s not going to heal. Steven needed something called a free flap, which consists of both skin and the tissue beneath it, including a deep layer of tissue called the fascia, along with its blood supply.” Using a microscope, the surgeon mapped out the tiny blood vessels on the tissue flap and the foot, and joined them. The delicate procedure took about four hours.

Good News and New Hope

The operation was a success and Doyley’s chances of needing an amputation dwindled. “I felt really good about it once he got his flap done,” Dr. McWilliam says. Doyley got precisely the right antibiotic therapy as well, overseen by one of White Plains Hospital’s infectious disease specialists. He even met with the hospital’s hyperbaric oxygen team, to see if the therapy they administer — in which a patient breathes pure oxygen in a pressurized environment to accelerate wound healing — would be useful. In the end, they decided he was healing so well he didn’t require the treatment.

After three weeks, Doyley returned home, and several months later his foot was stable enough for Dr. McWilliam to remove the external fixator. Doyley still sees Dr. McWilliam for checkups, and initially also worked with a physical therapist to help him walk more comfortably and improve his foot’s flexibility. These days, he mostly does the recommended exercises on his own.

“I’m able to walk on the foot a lot more now,” he says. “I’ve been in the gym for a couple of months, and I’m working my way up to running. I’ve had good days and bad days, but now I have more good days. I have more great days, actually.” He credits White Plains Hospital for helping him get back on his feet — literally. “I wouldn’t be in this place right now if it wasn’t for them,” he says. “I also work at a hospital, so I know White Plains Hospital’s care is extraordinary.”

Going Out on a Limb

When a patient is facing the possibility of an amputation, White Plains Hospital’s Limb Preservation and Restoration Program offers much-needed hope. The team is comprised of top specialists:

PODIATRY: Drs. Michelle Castiello, Edward Costa, and John Cappa

VASCULAR: Drs. William Suggs, Ratna Singh, and Dalila White

ORTHOPEDICS: Dr. James McWilliam


WOUND CARE CENTER: Dr. Joseph Cavorsi

Working collaboratively, the physicians use the latest therapies and technology to treat wounds resulting from diabetes, radiation, infections, and other causes. The goal is simple: to help patients preserve their limbs so they stay mobile and are able to return to work and activities. It’s not merely about keeping a patient’s body intact — it’s about helping them keep their quality of life as well.

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