Concluded Case

A 50 year old female got her foot burned while she was cooking on the chulah 3 months ago. A blister was formed for which she applied cream on the area but it continuously progressed to the present condition. The patient is known diabetic for 12 years. There is no history of TB, HTN, asthma or any thyroid disorder. No significant family history. The ulcer is having the fruity smell.on examination the sensation in foot was absent diagnosis?

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Diabetic foot ulcer MANAGEMENT :- Arterial color doppler, nerve conduction studies and daily RBS should be done. Strict diabetic control, antibiotics (after culture and sensitivity testing), debridement, dressing, rest and skin grafting after good granulation tissue formation.

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Diabetic foot , severe foot infection, necrosis, tendons are exposed, uncontrolled DM, probably going in for diabetic keto acidosis Both neuropathy and occlusive peripheral arterial disease due to DM may be present. Arterial colour Doppler, and nerve conduction studies should be done Tight diabetic control with insulin, suitable antibiotics, debridement, dressings, rest, and skin grafting after good granulation has formed are standard line of management. Patient education about DM, it's complications and their prevention will go a long way to avoid such disasters Good reporting

Diabetic foot ulcer. 1.Remove all the necrotic tissue except the tendon Though tendon is functionless,it keeps the toe in neutral position.If you remove the tendon ,the toe will go for plantar flexion deformity due unopposed action of plantar flexors. 2.After debridement do dressing with alginates, If absorbs exudate and keep the wound dry,therby it accelerates wound healing. Other points have been discussed by others.

Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

It is a case of diabetic foot ulcer with involvement of tendon.The management should be strict control of diabetes ,wound dressing,debridement , broad-spectrum antibiotic , and consultation with plastic surgeon

Diabetic foot Manage llike that Skin cover when fit

Diabetic foot ulcer MANAGEMENT :- Arterial color doppler, nerve conduction studies and daily RBS should be done. Strict diabetic control, antibiotics (after culture and sensitivity testing), debridement, dressing, rest and skin grafting after good granulation tissue formation.

Due to uncontrolled DM wound become worsen. Aseptic wound debridement Send pus culture Daily BLS Start with inj.pipzo Inj.pan Use collagen dressing daily after granulation change to oint.placentrax and alternate day dressing T.Kinetozyme D Multivitamin with antioxidants Sugar free protein supplements

Debridement and skin graft

Reconstruction surgery within stipulated time period if amputated part is in bag

This pt should be in hospital, and I have never seen student treating pts. She will need skin graft even tualy.

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