70 years male DM on regular Rx this wound without any injury since 4 months doing daily dressing with Antibiotic coverage. no healing pls guide.



It is trophic ulcer . Control diabetes with insulin and diet. Pt shoud not walk or give any pressure on foot. Please dress with panchvalkal and haridraghrita and honey daily . Debridement is must. The wound will heal but you have to take care of foot otherwise recurrence is enevitable.


do X-ray to r/o osteomyelitis.

Good dear, Narayan, But Neuropathic Ulcer is never bone deep. As a matter of fact we need to take X Ray for completion sake

Try metrogyl p with calendula with aseptic precautions

This is diabetic foot ulcer. It requires surgery to remove all necrotic tissues, otherwise it will not heal. It will require amputation if not treated urgently. Antibiotics well not help till necrotic tissues are there.

during said period by surgeon.

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Yes its Diabetic foot ...u can give calendula 200internally n hypericum30.n apply calendula ointment

Dear Rajendra, Thanks again for your wonderful case presentation. This is a case of 1) T2DM 2) Large Non healing Neuropathic Ulcer other wise known as Trophic Ulcer other wise known as Pressure Ulcer. Investigations. 1) FPG 2) 2hr PG 3) HbA1c 4) RFT 5) Serum Electrolytes 6) ECG 7) Fasting Lipid profile 8) CBP 9) CUE 10) X Ray Foot AP & Lateral view. 11) Pus or Discharge for C/S 12) Vascular Doppler. Treatment. 1) Admit the case 2) Absolute bed rest 3) Foot end Elevation. 4) Appropriate Antibiotics 5) Meticulous wound debridement 6) Regular Callous removal at periodical intervals. 7) Daily wound dressings 8) Proper Off loading 9) Proper foot care 10) Proper foot ware. The wound would heal with in 4 to 6 weeks. Please don't use Spirit Hydrogen peroxide. Use only NS for Irrigation. Thanks again dear and all the best.

An important part I forgot to mention, Please switch over to basal bolus insulin regimen and control DM meticulously which is most important in the treatment.

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it is a case of diabetic foot requires surgical debridement for dressing - co-mupimet powder+ampucare lotion chandraprabha vati 2tds sukshm trifala 2bd nishakatkadi kashay 10 ml bd gandhak rasayan 1 tds trifala churn 1 tsf hs

Dear sir adv 1.tab.arogyavardhini 60+kaishora guggulu 60+amruta guggulu 60+triphala guggulu 60 mix all together make fine powder and adv 1/2 spoon bd with maha manjishtadi kashayam 2.wound wash with triphala kashayam 3.dressing with jatyadi tail 4.good control of DM

Thanks...... s. kumar

Leech therapy needed jatydi oil localy dressing tab nimb twak tab gilloy, cleaning regular wid triphla decoction


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if pt is diabetic then it will require surgically removed necrotic tissue under controled blood sugar with immune support with rest ...see for blood culture

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