Ulcer of left calf

A 69 y/o/f presenting for fatigue from doing laundry and getting ready for checkup -Pt states son was exposed to two people at work that had COVID, and he came by her home to drop something off. States he didn't come inside. -Her son was sent home from work for three weeks. -Pt called and told nurse that she was around her son who was exposed to people with COVID. Ulcer of L calf -Pt reports the last time the nurse saw her wounds she said they were looking better. -Pt states taking good care of her wounds. -Reports the nurse is wrapping them differently with the gauze instead of using tape, inflammation decreased in this way. The pain comes back every once in a while if she doesn't eat or take the pain medicine. Past Medical History HTN, Chronic diastolic congestive heart failure, Epigastric hernia, Gait instability; GERD, Heart murmur, systolic; History of hernia repair; History of uterine cancer. What are your suggestions?

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Presuming that she can be diabetic as in history every existing disease and update mentioned but nothing posted about glysemic index so first check glysemic index. In view of her medical history her immune system is compromised. I am of the opinoin that this episod can not be related to Covid 19. Chronic ulcers or non-healing ulcers are defined as spontaneous or traumatic lesions, typically in lower extremities that are unresponsive to initial therapy or that persist despite appropriate care and do not proceed towards healing in a defined time period with an underlying etiology that may be related to systemic  involvement. I have read about treatment of chronic non-healing ulcers using autologous platelet rich plasma.. Consult vascular surgeion.
Her leg ulcer is not related to any COVID disease. As there is history of uterine malignancy, gait instability , hypertension with chronic diastolic congestive heart failure- this leg ulcer is not healing because of her lowered immunity , associated peripheral vascular disease and decreased blood supply to limb . Get a colour doppler study of lower limb vessels done .to assess vascular flow to lower limb . Treatment- Elevation of limb at night Tab cilostazol 100 mg B.D to improve vascular flow. A little debridement. Topical dressings with mupirocin ointment after cleaning with betadine
Non healing Ulcer ( due to diabetes, immunocompromised , Vasculopathy ) not related to COVID 19. Needs further investigation and evaluation to conclude and treatment plan. Reassurance and counciling required. Multivitamin and antioxidant orally. ASD with betadine lotion apply sofra tullu gauge cover. Analgesic and antibiotics orally. Multivitamin and antioxidant orally. Keep legs raised . Wait for final confirmation after investigation.
Thanks Dr Vipin Bihari Jain
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A CASE OF LEG ULCER WITH PAST HISTORY OF HTN,CHF, HISTORY OF UTERINE CANCER LEADING TO IMMUNOCOMPROMISED PATIENT .THE TREATMENT IS BROAD SPECTRUM ANTIBIOTIC ANALGESIC , HYDROGEN PEROXIDE , MUPIROCIN OINT DRESSING WITH ZELONET AND ADVICE RBS,PPBS , DOPLAR STUDY OF THE LIMB.
Thank you Dr.Dinesh Gupta sir
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IT'S A..CASE OF.. ? VASCULOPATHIC ULCER.. ? STASIS ULCER.. NEED'S TO WORK OUT AS PER PROTOCOLS AND NECESSARY INVESTIGATIONS.. WITH SURGEONS OPINION FOR WOUND MANAGEMENT.. WITH SURGEONS OPINION..
Tnx Dr Vipin Bihari Jain
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Appears to be nonhealing stasis uicer Treatment Amoxicillin500mg tds Hydrogen peroxide cleaning Mupirocin ointment dressing Blood sugar examination
SUGGESTIVE OF CHRONIC NON. HEALING ULCER NEEDS. FURTHER. EVALUATION ADVISABLE STANDARD PROTOCOL
It is nonhealing stasis ulcers Needs to avoid standing Normal saline dressings Sos ssg
Thanx dr Vipin Bihari Jain
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Non healing ulcer do DM covid19 xray debriment of wound daily dressing with megaheal aug 625 bd vitc ultra cet r/0 varicose ulcer
non healing ulcer d/d varicose veins ulcer debridement antibiotic anti inflammatory drug do color Doppler
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