What can we do for faster recovery of diabetic foot ulcer?

Patient's Query

Hello doctor,

My mother is 53 years old and she weighs 60 kg. She has fell down and tried home remedy for foot but, the foot has become worse. Now she is hospitalized. Her sugar level was 295 on the first day and now they have controlled it with insulin and today her sugar level is 180. What can we do for faster recovery? I have sent a photograph of the wound. Kindly view it and advice.

Answered by Dr. Hariharan V

Hello,

Welcome to icliniq.com. From the pictures, it is a clearly indicative of diabetic foot ulceration (attachment removed to protect patient identity).

Since she has uncontrolled diabetes, the nerves and blood vessels to the foot have been affected and have become ulcerated. The depth of the wound is large and it would take some time to heal. Extensive debriding (removal of yellow colored dead tissues) from the wound should be done twice a day and dressing should be done.

This must be the management for the first week. Intravenous antibiotics should be given, pus must be taken and given to the lab for culture and sensitivity (to know which bacteria is present and which drugs will work). Then appropriate antibiotics should be given along with twice daily dressing.

The yellow slough should disappear slowly and red colour tissue should appear (only then it is healing).

Do not discharge her now itself, since there is a chance that the underlying bone can also be affected if necessary care is not given (osteomyelitis). So, my advice is to make her stay in the hospital for one week. They will control infection by antibiotics and control blood sugar using insulin. Once red tissue appears, she can be discharged.

For the next week take her to nearby doctor for dressing twice or once daily. She has to continue insulin until the wound heals completely. She also has to take antibiotics for the next week also.

After that, you please learn how to do dressing and do dressing at home twice a day. The wound will heal slowly only, since her blood vessels and nerves are damaged due to diabetes.

The Probable causes:

Uncontrolled Diabetes - Neuropathy

Investigations to be done:

Pus culture and sensitivity, blood sugar levels and HbA1c

Treatment plan:

Dressing for three to four weeks, drugs for 2-3 weeks and insulin until the wound heals completely.

Preventive measures:

All diabetic people must check both their feet while bathing every day and if any abnormality appears, should consult the doctor immediately.

Regarding follow up:

For further follow up, consult a diabetologist online.---> https://www.icliniq.com/ask-a-doctor-online/diabetologist

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