Right foot ulcer with pain - Dx? Mx?

56 years old male complains of pain that right foot with an ulcer. This ulcer is present for 5-6 months. Sometimes patient noticed pus discharge. It is most likely a diabetic foot ulcer as the patient has a history of diabetes with poor control. He is not on any medication. No other medical history. He has a family history of diabetes. HBa1c is 9.2 s. creatinine 2.1. Please recommend the treatment plan.

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IT'S A..CASE OF.. ? DIABETIC FOOT ULCER.. WITH UNCONTROLLED DIABETES.. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. * BLOOD CBC.. * URINE ROUTINE.. * BS..FASTING..& POST MEAL .. * SWAB C AND S EXAMINATION.. * X-RAY STUDY.. * COLOUR DOPLAR STUDY.. NEED'S.. STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION .. FOR ..BETTER PROGNOSIS.. * WOUND MANAGEMENT WITH SURGEONS OPINION.. CLEANING DEBRIDEMENT AND DRESSING WITH MUPIROCIN.. * BROAD SPECTRUM ANTIBIOTICS COVERAGE WITH NSAIDS AS PER REQUIREMENT..
Tnx Dr Vipin Bihari Jain
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Non healing DFU over callosity caused due to abnormal pressure point, improper footwear, may be underlying deformity & uncontrolled DM. Callus trimming Offloading diabetic footwear after foot mapping (podiascan) Diabetic socks Control of DM & neuropathy Avoid barefoot walking even inside the house Better to start insulin which is safe in Nephropathy (Creatinine-2.1) & HbA1c 9.2% Daily dressing of wound with NS irrigation and Mupirocin Oint Systemic antibiotics if infected with
Diabetic ulcer nonhealing Poorly controlled diabetes hba1c is 9.2% Also pt has DKD as sr creatinine is 2.1mg This ulcer needs debridement with irrigation with h2o2 and NS and dressing with bactigrass Broadspectrum antibiotics like amoxyclav625mg 1bd and tab Lenazolinid 600mg 1bd Strict control of diabetes with insulin Offloading of wt on great toe Proper footwears
Thanx dr Vipin Bihari Jain
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Diabetes in this case is to be controlled Debridement of ulcer to be done with dressing under strict asepsis. Broadspectrum antibiotics to be given Vitamin C and antioxidants to be given
Debridement of ulcer along with H2O2& NS wash. Strict control of sugar levels. Apply muciporin ointment locally along with sterile dressing. Antibiotics, analgesics.
Diabetic foot ulcer. Debridement under strict aseptic condition. Application of sterile dressing, Broad-spectrum antibiotics. Strict glycemic control needed.
Cleaning of ulcer with H2o2 and NS solution Broad spectrum antibiotics Control on blood sugar level
POSSIBLY.. NON. HEALING ULCER... SECONDARY. TO ..C. K. D AND D. M
Diabetic foot ulcer. Treatment agree with Dr Agarwal Sir.
Thanx dr
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The location of ulcer is on weight bearing area The edges are vertical With necrosis at base It is a long standing ulcer All above finding indicates that it is a neuropathic ulcer, causes by decreased sensation or by absence of sensation Strict control of blood sugar with insulin , most of the oral hypoglycemic agent are contraindicated in renal failure Glargine insulin can be used as basal insulin, it is more effective because of its uniform and 24 hours duration of action Off loading of ulcer is required - it can be done by, a) Complete bed rest or b) Front ortho wedge type of footwear Limb elevation Antibiotics Atorvastatin, ecosprin and Cilostazole
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