Concluded Case

DIABETIC FOOT ...WITH UNCONTROLLED DIABETES..

Diabetic patient having uncontrolled diabetes since 3 months during Covid had pain in 5th MTP area with minimal discharge, took 2 courses of oral antibiotic without any x ray from GP, local examination done online with me, area is swollen and hot...what should be done next..

(Edited)

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Concluded answer

Plan- surgical debridement and curettage of the head of 5th MTP with base of proximal phalanx and small Part of shaft , go through this same small wound, offloading with POP cast, IV antibiotic presently Linezolid with clindamycin( it has strong bone penetration) , dressing with hydrogel ( Megaheal or Silverex heal or Purilon) with hydrofiber sheet daily

All Answers

Must be a case of uncontrolled DM So investigations required are - FBS PPBS HbA1c Urea Creatinine Lipid Profile Uric Acid CBC ESR Urinalysis Urine Micral ECG Digital X-ray of affected foot Thoroughly debride the wound after taking all aseptic measures. If any bony involvement like osteomyelitis, then curettage of the affected bone. Insulin, antibiotics, daily dressing of wound, offloading.

Thank you doctor
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Uncontrolled diabetes with cellulitis foot with a small infected at the base of great toe. Strict glycaemic control after estimating blood sugar ana HbA1 c. Blood examination, kidney function, lipid profile Xray of foot Antibiotic inj Ceftriaxone 1 gm I v with Salbactum 500 mg Anti inflammatory Analgesi.c All to continue 2-3 days if any sign of resolution to continue if no sign of resolution the Management of the wound Wound does not look much unhealhy, cellulitis present. Explore the wound to see any collection then drain the abscess cavity with th debribement of the margins and removal of slough present Regular dressing after irrigation with H2,O2 and normal saline Pus for culture sensitivity for proper antibiotic.

Thanks Dr Y D Sharma Devgan
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Uncontrolled diabetes with diabetic foot infection Control diabetes with insulin Control foot infection with aerobic and anaerobic antibiotics Desloughing may be reqd Assess for neuropathy and vascular issues

Plan- surgical debridement and curettage of the head of 5th MTP with base of proximal phalanx and small Part of shaft , go through this same small wound, offloading with POP cast, IV antibiotic presently Linezolid with clindamycin( it has strong bone penetration) , dressing with hydrogel ( Megaheal or Silverex heal or Purilon) with hydrofiber sheet daily

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