It is diabetes wounds what treatment give better result



This is a case of 1) T2DM 2) Neuropathic Ulcer, non healing, infected. 3) Deformed foot ??? Charcot's Foot. This case needs some history. Because this is not a spotter. Male or female Age of the patient Duration of Diabetes Duration of ulcer. Any associated complications. Investigations 1) FPG 2) 2hr PG 3) HbA1c 4) RFT 5) CBP, ESR 6) CUE 7) X Ray Rt Foot AP & Lateral view to see the foot deformity, To r/o Osteomyelitis. 8) Vascular Doppler to r/o obstruction. 9) C/S discharge Treatment. 1) Admit the patient and treat 2) Absolute bed rest 3) Appreciate antibiotics against Gram positive Gram negative Aenarobes 4) Meticulous wound Debridement by Surgeon till the wound bleeds fresh 5) Margins of Ulcer must be healthy 6) Proper offloading 7) Orthopedic surgeon to correct the bony deformity 8) Proper Foot care & Foot ware. 9) Change the antibiotics as per the C/S 10) Daily wound dressings. 11) HBOT Hyper baric Oxygen Therapy First and foremost is Meticulous control of blood sugar levels by basal bolus regimen. Maintain adequate hydration Correct Electrolytes imbalance. Proper counseling at the time of discharge.

What happened to the great toe and second toe, disarticulated or not visible in pic ???

First of all I fully agree with Dr Krishna Mohan. Apart from suggestion of Dr Mohan what you can do is to start insulin to control hyperglycaemia , absolute rest to that particular good, regular dressing, antibiotics and tetanus toxoid injection depending upon the immunization status.

Thanks dear Narayan Chakraborty

Agree with Dr Krishna mohan

Thanks again Dr Devi

agree with dr krishna mohan

Thanks dear Ramesh

Agree with Dr. Mohan.

Thanks Dr Parvez

existing the wound tx insulin

existing the wound tx insulin

Use clindamycin in antibiotics. Rest bring down the blood sugar level ..

agree with Dr krishna sir

Thanks again dear Kunal

Rule out for keto acidosis and dr Krishna Mohan diagnosis is keen

Thanks a lot dear Nagamani.
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