It is a chronic skin lesion, involving Nerve thus causing Parasthesia, & Burning sensation due to chronic ulcer. D.M. to be ruled out, & needs stringent CULTURE/SENSITIVITY study to give correct Treatment then one has to go for SKIN GRAFTING. Dr Brahmananda.

Investigation for Blood sugar F & PP Culture of pus Dressing of wound with Betadine solution + Muprison + Neosprin powder dusting Alternative dressing Inj lincomycin IM BD inj Cetrioxozone 1 gram iv slow Tab Ceftum 500 BD Tab Ornidazole BD Tab Chymotrypsin BD Tab Aceclofenac Paracetamol saeropeptidase BD Tab Pantaprazole OD Tab Multivitamins OD for 3 weeks .

Ulcerative lesion, advised B- complex with zinc, antibiotics, anti inflammatory. Pain is due to open nerve endings.

Sir proper history is required to work on the case . After investigations to detect the associated organic diseases and wound becomes healthy skin grafting is required

I request the presenting doctor to write a brief history along with the photos. Without knowing about the cause of such a large area being ulcerated, the diagnosis can not be definitive. I agree with Dr Giridhar's view about the ulceration and will add that it can need skin graft to cover bcz of such a large denuded area. Pregabalin and tramadol preprations will help relieve the pain

Exactly dear Ashok

Cleaning betadin losion sofrtule pocket dressing day by day petroleum jelly apply soframycin cream ceftum 500mg tab nise MDT tab limcee daily one chewble

split skin grafting solves the problems in 10 days. Ideal time to do it. Straight forward solution and a definite one too.

Rule out DM first. How he developed this ulcer? proper history is important . parasthesia & burning sensation keep in mind Hansen's disease also.

present state of the wound is healthy well formed granulation tissue. It needs skin grafting for faster recovery. Underlying main problem has to be addressed too. simple aseptic saline dressing will do.No need of any antibiotic. Pegabolin and tryptomer orally.

Do the routine investigation. How this wound progressed? Clean the wound with normal saline dressing with lignocaine gel n antibiotics orally according to sensitivity from the culture from wound site. General tt according to pathological report

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