A case of non healing ulcer leg. Please share your suggestions

A case of non healing ulcer leg. Please share your suggestions for management



Wound cleansing 2-3 times a day with plenty of NS and thorough drying. Avoid or minimize usage of Betadine or peroxide. Followed by: Dusting with antibacterial powder such as Nebasulf. Mupirocin or Hydroheal ointment application; Dressing with sterile cotton and gauze or Mepilex hyrogel dressing if ulcer is oozing excessively; Avoid pressure on affected area and also avoid any friction rub from bed/ clothes. Massage the surrounding area with oil to promote circulation. Advise a high protein diet consisting of eggs/ soy etc with adequate carb intake. Avoid compression stockings, tight clothing and suggest using an air mattress to prevent further pressure ulcers.

Also, surgical consultation to assess suitability for grafting.

Wounds appear to be healthy..except for the exposed tibia at the wound over the anterior aspect of leg. Since it's a chronic wound I would differ from the regular dressings. My advise would be scraping of the superficial layer of granulation tissue, refashioning of the edges followed by the skin grafting for the wound new ankle and perhaps a median sural artery flap for the anterior wound.

Healing ulcer. Adv. Cleaning and dressing wound every day with NS and metron sline. Give some antibiotic and analgesic.Collegen powder may be use if wound is sterile and may need debridment and skin grafting checking BSL and ruetine blood investiation.

Hyperpigmentation, lipodermatosclerosis with sloping edge of the ulcer. Hence most likely venous ulcer. Adv- venous colour dopplar. Hypergranulation tissue is present over the ulcer so, clean with hypertonic saline and triple layer dressing

Almost the wound's looks healthy with little dead skin along with border line, with all aseptic precautions clean with NS & using BACTIGUAS /SOFRATULLAE, daily dressing. Next step is SKIN grafting with Experts opinion

Thanks to all of you

As both wounds are covered with granulation tissue so after culture and sensitivity of wound swab patient can be taken for surgery asap. This need tangential excision of translation and Skin grafting. Thanks

Aim to know the cause of ulcers, is it varicose , diabetes, malignancy or something else. Aim is to treat primary cause. During that period wound to be taken care of with regular dressing and hygiene

Bad management to let it go to this stage. Surrounding skin looks dead ,it looks healthy granulation,do a culture if no infection only answer is skin graftust exclude malignancy.

Incision biopsy of both ulcers separately for a tissue DX. D.D. 1 Tb ulcer2. Syphlitic gummatous ulcers 3. Malignancy . Doplar study for veonous causes Review ?DM

Dear Dr Singh The Raw areas appear to be fit for resurfacing by skin grafting. Get a culture dine and start n saline dressings, and if everything is okay go for grafting

Sir what's ur take for the wound over the shin...I think the tibia is exposed

View 1 other reply

Load more answers