severe diabetic wound

Age 42 years Diabetic have been suffering with severe wound inflammation & tissue necrosis. Shown in picture. His Sugar levels are now controlled with Insulin. No HTN, He has been treated with many antibiotics but not controlled . What would be further evaluation kindly do DX or Rx treatment for this patient.

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All ready well explain by all senior i add few such as Biofil AB ccrystalline powder - Assess, debride and clean the wound according to your protocols - Apply BioFil -AB Particles sufficiently to cover the wound surface - With a heavily draining wound : Cover with an absorbent dressing and change if necessary - With a minimal draining wound : Cover with a secondary non-absorbent dressing and change as required - Remove the secondary (cover) dressing daily as indicated by the amount of draining - If secondary dressing is adhered to the wound, irrigate with saline solution until dressing loosens and lift gently - Irrigate the wound with saline, then OXUM Spray to cleanse the area thoroughly - Reapply BioFil®-AB Particles as befor

Thank you doctor
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ULCER ON..LOWER LEG..WITH.. DIBETES.. NEED'S.. STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. BS.. ANTIBIOTICS WITH NSAIDS AS PER REQUIREMENT.. WOUND MANAGEMENT WITH SURGEONS OPINION.. SWAB C AND S EXAMINATION.. BSR .. HBA1C..

Tnx Dr Vipin Bihari Jain sir
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Chronic non healing diabetic ulcer leg Ulcers with unhealthy granulation tissue. Adjacent areas of necrosis are yet to separate. Suggest To continue insulin for tight control of DM Surgeon opinion, debridement of slough , periodically Sofratulle dressings Pus culture and sensitivity, and antibiotics according to report. Improve general health with proteins and vitamins. Arterial color doppler to assess vascularity vascular surgeon opinion . Cilastazol Rest Skin grafting later

Thank you,Doctor
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After controlled diabetes swab culture and sensitivity to be done, debridement of wound and management under surgeon's supervision to be done

Thanks Dr. Kute Ankush, Dr. Krishnan Pichumani, Dr. Rajendra Rai
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Sloughing tissue Control blood sugar level Hydrocolloid dressings :- a moist wound healing environment and promote autolytic debridement of necrotic and sloughing tissues. Send wound culture and try appropriate antibiotics hyperbaric oxygen therapy Topical antibiotics( Neomycin, Gentamycin, and Mupirocin have good antibacterial coverage )have broad-spectrum antibacterial coverage which lasts for 12 h and are less toxic.  Metronidazole gel has good anaerobic coverage and helps in maintaining a moist wound healing environment Sisomycin and acetic acid concentration are effective against Pseudomonas, other gram-negative bacilli, and beta hemolytic streptococci wound infections

Thank you doctor
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Essential blood sugar Fasting, PP, HbA1c , Hb% , ESR, UREA ,CREATININE, and HPE. URINE RE, ME, C&S. Proper antiseptic dressing regularly and cover with bandage. Control blood sugar fast. Choose antibiotics in sensitivity test of urine for faster healing. And multivitamin minerals and antioxidant regularly.

Thanks Dr Shivraj Agarwal Sir
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Abundant necrosis need debridement frequently and NS dressings once granulation is good adv ssg

Thanx dr Kute Ankush
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Non healing ulcer go for colour Doppler study & after that skin grafting is only solution otherwise amputation of lower limb

Lot of thanks
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Diabetic foot

Proper debridement followed by vaccum assisted closure dressing

Thank you doctor
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