Diabetic patient with laceration

66 year old male with 10 years history of DM type 2 on Rx metformin tab 500mg 1x2 and insulin 5 unite. Presented today with painless laceration injury which was happened buy trauma to the edge of a chair. RBS:407mg/dl BP:140/85 Distal pulse was palpable with positive pin prick sensation of both feet Management: Debridement, primary suture meropenem vial 1x3 for 5 days change to Amoxicalve tab 1x3 for 7 days. With wound debridement each day Any father points will be appreciated.

3 Likes

LikeAnswersShare
Just keep strict control of sugar which is very high keep him on insulin Keep asepsis As once wound goes infected it will be difficult to heal Yes nice work you have done by primary sutures Niw make it heal
Thanx dr Ashok Leel
0

View 5 other replies

Very high sugar , control is compulsory Antibiotics Ceftriaxone, Gentamicin, and iv metronidazole to be given Strict asepsis required
Gross lacerated injury of the heel with active bleeding, the only bonny structures which may come in relation to this injury mainly calcaneum. Xray heel AP and LAT veiw The tendo achilis is not supposed to get injured still then it should be tested to detect any injury or laxity of TA. Strict glycaemic control Clean the wound by irrigation of H2O2 and normal saline The wound to be closed with suture. Before that if xray dhows any fracture calcaneum if necessary by k wire fixation Inj Ceftriaxone 1 gm iv bd for 7 days Inj Metrogyl one bottle tds Anti inflammatory and anal gesic Care shoud be taken wound does not get infection.
Palpate both the tibial artery , SPO2 of the toes ,and needle prick with 20G needle..and check the temparature of the toes.NS lavage and clean the wound with excision of all the nonviable tissue and clots..just give stay suture and CRS drain.no negative drain.evaluate everyday at least for 2days , if no worsening the condition..final debridement and cleaning with H202 again.and sutured the wound ..obviously pt should be on insulin..and monitor cbg 6hr and good antibiotic coverage .thank you
IT'S A..CASE OF.. UNCONTROLLED DIABETES..WITH.. POST TRAUMATIC..GROSS ..LACERATED.. INJURY TO..HEEL NEED'S.. * STRICT GLYCEMIC CONTROL FOR.. BETTER PROGNOSIS.. WITH.. ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. * X-RAY STUDY..TO R/O..UNDERLYING INJURIES.. * SURGEONS OPINION FOR WOUND MANAGEMENT.. SUTUREING.. * BROAD SPECTRUM ANTIBIOTICS COVERAGE AND NSAIDS AS PER REQUIREMENT.. * REST AND FOLLOW..
Tnx Dr Vipin Bihari Jain
0

View 2 other replies

Primary suturing of laceration Strict control of blood sugar with Glargine insulin, which can be used as basal insulin to control both fasting and post lunch blood sugar Appropriate Antibiotic to cover gram positive organism e. g. Amoxicillin clavulanic acid or linezolid Ecosprin + Cilostazole to improve circulation
Regularly evaluation of bSL and through assessment of condition. Daily dressing with betadine lotion. Aseptic and antiseptic condition must be ensured. Analgesic antiinflammatory orally.
Thanks Dr Vipin Bihari in
0

View 3 other replies

U have done quite well but keep strict sugar control and also go for blood culture to exclude any sepsis which is likely in such high sugar cases if even little careless
Primary suturing should be done along with antibiotics and analgesics. Strict control of blood sugar levels. Correction of anaemia (if present). X-ray foot...
Strict control of the diabetes,wound closure and dressing regularly,Inj.TT, BROAD SPECTRUM ANTIBIOTIC ANALGESIC MUPIROCIN OINT
Load more answers

Cases that would interest you