49yrs pt.suffer from this type of foot ulcers since 7month.he has no diabetes.pl.suggest the treatment
Nondiabetic Extensive Foot Ulcer. Foot ulcers also commonly occur in people without diabetes . As with diabetic foot ulcers, these foot ulcers may develop due to overlapping factors including neuropathy, peripheral arterial disease, pressure overload, trauma and foot conditions such as fissures and callosities Rx. Antibiotic,Antiplatelet or anticlotting medications to prevent a blood clot. Topical wound care therapy Dressing to b done regularity. I think More needed the investigations. Adv:- Ulcerated Tissue biopsy. X-ray foot. HIV CBC Hb1Ac Completely Agree to "Dr.Mteeve Sir"
Sir maintain proper hygine Sterile dressing Raktmokshan Gandhak rasayan 2 bd Chndnasav 20 ml bd with water Satdhaut ghrit lepan and dressing If not improvement then skin grafting will be best for this case.
More history sir: - How did it begin? Any trauma involved? Any intervention made? Why the late presentation to the hospital? Family Social History? - Any pain? - Loss of sensation to what extent? More lab works. CBC. UECs. Hb1Ac. HIV status. Imaging - Foot X-ray - Rule out bone involvement. Meanwhile :- 1. Tissue biopsy for histology. R/o malignancy. 2. Extensive tissue debridement and revascularization in theatre under general anesthesia. 3. IV flucloxacillin QID & IV tramadol (or analgesic of choice) - If bone involved, consider IV Clindamycin. 4. Daily wound cleaning and dressing. 5. Possible skin grafting.
Detailed history required regarding how it started, any history of trauma, any history of any Septsis, any history of intervention, any treatment by local treatment. Full investigation Culture sensitivity for proper antibiotic Xray to exclude any bonny involvement Proper debribement of the wound specially the unhealthy margin of the wound and hypergranulation tissue. Regular dressing Blood transfusion may be given to enhance the formation of healthy granulation tissue and dressing to be done regularly till the wound is healthy and welformed granulation tissue. Later on split skin grafting may be planned.
Proper investigation to find out the cause of such extensive ulceration.meticulous debridement and dressing.skin grafting.
Severe ulcerative leads to gangrine....meticulous debridement and proper dressing and skin care required......clean with NS , and wound heal spray and apply megaheal gel and covered with tule pack , proper dressed ...... Go for braod spectrum antibiotics injections like pippercilin and tazobactum associated with Trypsin and chymotrypsin tab , lenizoid 600 mg tab , vit C tab orally as per recommend ....along with antioxidants ......it will take longer treatment be patience .......
Chr. Non Healing ulcer Diabetic foot Perupheral arterial Ds.
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