Leg ulcer

30 yr old, male, from low socio - economic , p/w bilateral lower limb ulcer since long time Chief Complaints Bilateral lower limb ulcer since long time ( exact time don't know) With hemorrhagic discharge on touch and on injury. Physical Examination Pallor, cachexia Approx 12x10 cm sized ulcer over left lower limb onver ankle joint with hyper-granulation with Slough with surrounding hyperpigmentation Approx 6x4 cm sized ulcer with Slough present at right lower limb at ankle joint Investigations Hb- 5 Diagnosis Bilateral lower limb ulcer due to ?? vasculitis Management HB electrophoresis Correction of anemia High Protein diet with protein powder Bilateral lower limb arterial and venous Doppler Margin biopsy Dressing with normal saline and CuSO4 powder for hyper-granulation Split skin grafting

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Venous stasis ulcers Hypersiderosis is noted Peripheral vasculopathy Ns irrigation and dress with placentrax gel Consider SSG

Thanx dr Rajesh Yadav
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Arterial and venous assesment. Regular dressing, no purulent discharge so N.S dressing should be sufficient. Later SSG once healthy granulation is formed

Use cuso4 for hyper granulation. Inj@ placentrex IM OD--15to20day. Dressing with--muprocin+megaheal+placentrex. Ankle+knee exercise. Control DM with Inj Glarjin +ink. Lispro(if+nt) crpe bandage may be used (for venous steaks)

Skin graft after control of infection

@dr SS Bajpei

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