40 year male dm type 2 plz guide for treatment presented with upper limb swelling and uncontrol hyperglycemia



Dear Prashant Mos important is to control disbetes Than due care should be given to mx of hand in form of DEBRIDEMENT ASD with septiloc Hand Splintage and elastocrepe bandage institute antibiotocs according to culture sensitivity Latee this ll reqiire resurfacing by SSG _flap

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see x ry fr any bony envolment dopller fr blood supply if supply adequate no bony involved tt debridment proper dressing inj pipp+ tazo be 4.5gm bds anti inflammatory controll dm by insuline adv to improve life style if good granulation then if need sgft

Take on insulin control for diabetes Antibiotics Splint support Dressing SSG/ flap cover as time tell

Tight glycemic control. Wound debridement and daily dressing. IV antibiotics. The distal thumb is already gangrenous, so needs amputation. Once wound healthy, skin grafting will be required for covering the defect.

Good glycemic control with debridement and dressings should be done first and later on wound cover should be done ..most probably a flap cover is needed

Control of diabetes is of paramount importance,and than treat the wound simultaneously,take a culture and sensitivity.and use appropriate antibiotics, dress with bactigra , but all will depend on pt. Motivation.

Need debridement of thumb, dorsum of hand and volar aspect of wrist Thumb probably not survive due to infective involvement of vessel  Need flap cover or ssg later after granulation comes after daily dressing

proper diabetic control sequential debridement and broad spectrum antibiotic coverage and subsequently plastic surgery is the mode of treatment in this case

I agred with Professor sudhir. Good control of DM. Mateculus debridement and dressing. And plan ssg. Sent pus for c/s and give antibiotic accordingly.


Control diabetes, sentiment of wound culture And sensitivity use appropriate antibiotic develope healthy granulation tissue and good blood supply. When ready go for skin grafting.

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