Great toe condition in a diabetic with poor glycemic control

63 year old diabetic with poor glycemic control presented with the condition as depicted in the image attached. Diagnosis and management?

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Diabetic foot Already great toe is lost Wound is not healthy Poor glycemic control Hence to manage at this stage Needs strict glycemic control by inj insulin and OHA Offloading of wt Debridement of wound as deep as possible Irrigation with NS and H2o2 Dress with placentrax and raw honey If healthy granulation is seen than opt for flap transplant Though efforts may be futile as gangrene has set in In that event amputation fore foot Procedure to be supported by broad-spectrum antibiotics Tab cefuroxime and Lenazolinid Vit c

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? DIABETIC FOOT .. WITH .. UNCONTROLLED DIABETES .. NEED'S .. STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH.. INSULIN .. OHA .. DIET PLAN .. ENDOCRINOLOGIST OPINION .. CLEANING DEBRIDEMENT AND DRESSING WITH ANTISEPTIC ANTIBIOTICS OINTMENT .. WOUND MANAGEMENT WITH SURGEONS OPINION .. BS..ANTIBIOTICS WITH..NSAIDS AS PER REQUIREMENT .. INVESTIGATE WITH..SOS.. HEMOGRAM .. URINE ROUTINE.. BSR..HBA1C .. SWAB C AND S..EXAMINATION.. X-RAY STUDY.. COLOUR DOPLAR STUDY..

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Diabetic foot Dermatitis? Squamous cell carcinoma Dermatitis? Management.. Biopsy. Surgical intervention..

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Strict control of diabetes Meticulous care of wound Skin grafting required after wound becomes healthy

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Rule out squamous cell carcinoma by biopsy .

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Looks like Non healing ulcer due to Diabetes. Raktamokhsan with leech Therapy may be helpful.

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SURELY A CASE OF DIABETIC FOOT GOING INTO GANGRENE. GANGRENOUS GREAT TOE DUE TO DIABETIC DERMOPATHY,,POOR GLYCEMIC CONTROL. RX,,, STRICT GLYCEMIC CONTROL WITH OHA AND INSULIN. DEBRIDEMENT OF WOUND DEEPLY . WASH WITH H2O2 NS & BETADIENE SOLUTION. DRESING WITH MEGAHEAL OINTMENT SOS FLAP TRANSPLANT BS ANTIBIOTICS ORALLY MULTIVITAMIN AND MULTIMINERAL SUPPLEMENT

POSSIBLY NON. HEALING DIABETIC . ... FOOT ADVISABLE H P E

Diabetic foot Adv- Debridement Strict glycemic control Regular dressing Higher antibiotics according to pus c/s