Concluded Case

27 years male has this wound x 15 days hit by foreign body advice

27 years male has this wound x 15 days hit by foreign body advice management

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Non healing ulcer with cellulitis of the surrounding skin, daily ulcer cleaning with betadine and hydrogen peroxide for slough removal, oral antibiotics like augmentin after sending swab from ulcer bed for culture and sensitivity, tablet chymoral forte tid, limb elevation, no need for crepe bandage, can apply debridase ointment since there appears to be slough present in the ulcer floor, get xray foot also for any retained pieces of foreign body or underlying bony injuries , tablet vitamin c BD, send his CBP, tablet Zerodol-sp BD, tablet pantop 40mg once daily empty stomach, multi vitamin tablets as well

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There is infected ulcer just above medial malleolus With surrounding redness and oedema He must have been through Antibiotics by now Please send wound swab for culture Linezolide 600 mg twice a day for 7 days (it has only Gram positive spectrum and highly effective) Limb elevation (very important) Crepe bandage Check for diabetes, immunocompromised status

May I know why to apply crepe bandage sir?
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Rule out DM. Restrict movements .
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Non healing ulcer with cellulitis of the surrounding skin, daily ulcer cleaning with betadine and hydrogen peroxide for slough removal, oral antibiotics like augmentin after sending swab from ulcer bed for culture and sensitivity, tablet chymoral forte tid, limb elevation, no need for crepe bandage, can apply debridase ointment since there appears to be slough present in the ulcer floor, get xray foot also for any retained pieces of foreign body or underlying bony injuries , tablet vitamin c BD, send his CBP, tablet Zerodol-sp BD, tablet pantop 40mg once daily empty stomach, multi vitamin tablets as well

Agree
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History..investigations esp X ray for any remaining foreign body..antibiotcs..analgesics. antibiotic dressing..Tab Folic acid 5 mg helps heal fast..pt may need split thickness skin grafting.

Chitomesh SFcream b.d application
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Infected ulcer. Cleaning with betadin solution Dressing with mupirocin Inj -Ceftriaxone 1 GM bd x 5 days. followed by oral antibiotic

Thanks Dr. Abdul Majeed Sir
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First thing to do is send for cultre sensitivity. 2)hydrogen peroxide daily dressing.of possible vacuume dressing. 3)daily dressing shuld be done 4)get usg scan lower limb veins 5)rule out HIV status or immunocompromised status. 6)linazolid 600mg tab bd 7)inj metrogyl 200ml 1--1--1.

what is the role of usg scan in this case
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There is infected ulcer just above medial malleolus with surrounding redness and oedema.

Agree with others Get an xray It may show a retained foreign body In the end will need soft tissue cover by a plastic surgeon.

Infected Ulcer. Rule out retaibed FB N OR Other causes. As it is near mallolar bone-elevation n rest is neede. Explore n remove all slough n FB IF PRESENT.SEND PUS FOR C/S. THOROUGH CLEANING N DRESSING .Start Clindamycin 300 BD N OTHER MEDICINES TILL CULTURE REPORT COMES.

Rule out any pathology in the bone do wound debridement.Hydrogen peroxide saline wash and dressing with povidone iodine.Give broad spectrum antibiotics vitamin protein and apply crepe bandage to immobile the joint m

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