Concluded Case

Diabetic foot ulcer...

Female aged 73 years...Diabetic with DP Artery palpable, no pain came with great toe lesion .. please discuss treatment options... Blood sugars are 144 fasting and 176 Pp. A1c:- 7.3. Swab culture from lesion - no growth..

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Infected Diabetic foot ulcer healing now.. with good results
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This is a case of diabetic foot with neuropathic ulcer of great toe with cellulitis. Investigations FPG PPG HbA1C CBP RFT LFT Lipid profile TFT Serum electrolytes ECG Micral X ray of affected foot focus on the ulcer to exclude Osteomyelitis. Vascular Doppler of the lower limbs . Treatment is 1) Strict control of blood sugars by Insulin only. 2) Antibiotics 3) Tissue lytics like Trypsin and chymotrypsin. 4) Extensive Wound debridement if it doesn't involve the bone followed by regular dressings. 5) If bone is involved, only leftover option is amputation of great toe depending on involvement by a general surgeon or orthopaedic surgeon. 6) Offloading the foot is important. 7) Last and most important of all at the time of discharge is education of patient and her relatives regarding foot care.
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Diabetic ulcer with neuropathy that is why no pain. Wound shows the necrosis at the center Wound swab culture and sensitivity test Debribement of the necrosed skin with devitalized margin of the wound and let it bleed Daily dressing Antibiotic broad spectrum then as per sensitivity report. Strict control of diabetes with insulin X-ray of great toe to exclude bonny involvement.
IT'S A..CASE OF.. ? DIABETIC FOOT..ULCER.. * STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. * WOUND MANAGEMENT WITH SURGEONS OPINION.. * ANTIBIOTICS WITH NSAIDS AS PER REQUIREMENT.. * MULTIVITAMINS ANTIOXIDANTS.. * INVESTIGATIONS..SOS.. BLOOD CBC CT BT PT.. URINE ROUTINE.. BSR HBA1C.. COLOUR DOPLAR STUDY..
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SUGGESTIVE OF DIABETIC. FOOT WITH NEUROPATHIC ULCER..... GREAT. TOE... CELLULITIS.. ADVISABLE X. RAY...FOOT DOPPLER. STUDY REST. AS. PER. STANDARD. PROTOCOL
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Blood sugar management Debridement of wound. Regular dressing Broad spectrum antibiotic. Venous Doppler of leg Regular sugar checkup
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Diabetic foot Diabetic ulcer Strict control of diabetes Antibiotics orally Antibiotic T Bact oint dressings Tab Serra 2 B D
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Diabetic foot ulcer . Since there is no pain, likely to be Anesthetic foot. Since DP artery pulsation is there , likely thus is not an ischemic limb . It is better to do arterial colour Doppler. Location if the ulcers suggests footwear injury as cause of ulcer . Debridement, dressings, tight control of DM with insulin Celestazole, Neurotropic vitamins ,antibiotics, metronidazole , Flucanazole ,rest
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Apart from all treatment good nutritional support essential. Start Protein , MVI Infusion .
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Infected Diabetic foot ulcer healing now.. with good results
Diabetic Neuropathic ulcer Rx strict control of blood sugar
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