Concluded Case

Venous ulcer

40year old diabetics on controlled sugar levels history of surgery done for varicose veins now came with mild pus discharge on leg

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Concluded answer

Pus discharge on leg with perilesional hyperpigmentation is indicative of an impending varicose ulcer- although he has been operated for varicose veins . It ia a lymphatic infection - which is difficult to treat. He needs prolonged antibiotics Tab Linezolid 600 mg for at least 2 weeks A strict glycaemic control needs to ne achieved Dressings- megaheal gel and Elastic compression stockings will help

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Pus discharge on leg with perilesional hyperpigmentation is indicative of an impending varicose ulcer- although he has been operated for varicose veins . It ia a lymphatic infection - which is difficult to treat. He needs prolonged antibiotics Tab Linezolid 600 mg for at least 2 weeks A strict glycaemic control needs to ne achieved Dressings- megaheal gel and Elastic compression stockings will help

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Pus C/S...till then start iv linezolid and metrogyl and amikacin if ur and cr is OK..leg end elevated .and NS dress in with lycimond ..review after 5days ..pls

The only contraindications of elastic compression stockings are 1.Severe peripheral vascular disease 2.Severe peripheral neuropathy 3.Allergy to stocking material. In acute stage - over a 3- 4 layer dressing- there is no contraindication of elastic compression stocking .- in fact it improves venous and lymphatic return and helps in early healing

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It will be heartening to learn from the esteemed doctor who disagreed with my reply - as to the reasons behind disagreeing with my reply .If I am wrong please correct me and have a debate on the subject. I would also ask other members of curofy to tell me the reason - why my reply was wrong Thanks

Repeat the blood suger. Specimen for pus c/s should be taken.Antiseptic dressing required. In the meantime some broad spectrum antibiotic should be started( may be changed on obtaining the culture report.) Tab Dalon 500 mg twice daily may be started if not given before. Wound has to be cleaned.

Postphlebitic limb with ulcer Adv Limb elevation Pressure stockinette Strict control of diabetes Four layer velfour bandage is described for same

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