Muhamad Na'im B Ab Razak (jacknaim) is a fresh graduate Muslim Doctor from Universiti Sains Malaysia and waiting for the enrollment into the housemanship program. Ambitious in pursuing master program in emergency and traumatology medicine and loves to spent his free time joining humanitarian missions, writing and speaks as an amateur public speaker in motivation and comparative religion. [HOME]

Diabetic foot ulcer


Answers

1)Abnormalities
- redness of skin over the dorsum of the foot with ill defined margin
-pitting edema
-Ulceration of the fourth and fifth digit.

2)Infective diabetic foot ulcer with cellulitis

3)Investigation
Blood: FBC, Blood C&S, ESR, RBS, HBa1c
Imaging: x ray of the foot (AP& Lateral view), X ray of the ankle joint (AP & lateral)
Others: ABSI, Doppler ultrasound



Management
-Evaluate the extension of the lesion to determine whether this patient needs irrigation and debridement of the dead tissue only or need amputation.
-Excise any callosity
-Rest in bed with elevation of the affected foot
-IV antibiotic to cover for the polymicrobial bacteria. i.e; gram positive, negative and anaerobic.
-Optimize the glycaemic control and patient’s condition
-Patient education on foot care.