|
 Principles:
 Debridement
Off Loading
Dressing
Control of
Infection
Debridement:
Includes:
Surgical:
Remove dead tissues, hyperkeratotik rim,ulcer base till good amount of
bleeding occur
Autolytic:
Hydrogel for dry wound, calcume alginates for wet wounds.
Enzymatic:
Local collagenase & papain are used
Biological:
Maggots larvae of green blow fly (lucilia sericate, phaeniciasericate)
removes necrotic tissues
Mechanical: Non
selective painfull wet to dry gause dressings
Offloading:
Bed rest or
special foot wears which will off load the wound so as to prevent
pressure ischemic
necrosis of the wound
Dressing:
Povidone Iodene,
Acetic Acid, Hydrogen Peroxide used traditionally but they destroy glanulation tissues
& subcut tissues & may delay wound healing. Moist
dressing soaked in normal saline.
Recombinant:
Human platelet derived growth factor, recombinant human epidermal growth
factor are
recent advances in healing of the ulcers.
Human skin
equivalents like dermograft & graft skin are also useful
Vacuum assisted
closure is useful in weeping ulcer.
Infection:
Antibiotics as
per culture & sensitivitye
|
Diabetic Foot
This may not be
far off,
'if ignored' |
