Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Ray resection and primary wound closure
3%
91/2995
Oral antibiotics and local wound care
2%
51/2995
Local wound care and non-weight bearing in a removable boot
24%
731/2995
Surgical debridement, dressing changes, and IV antibiotics
55%
1645/2995
Transmetatarsal amputation
16%
466/2995
Select Answer to see Preferred Response
The wound described and shown in this question would be classified as a Wagner Grade 3 ulcer due to the presence of exposed bone. The ability to probe bone at the base of the ulcer is indicative of underlying osteomyelitis and this should be initially treated with surgical debridement, IV antibiotics and local wound care. Pinzur et al provide an overview of diabetic foot care and address physical examination, patient education, and basic treatment guidelines. Grayson et al evaluated 76 foot ulcers and found that palpating bone on probing the pedal ulcer had a sensitivity of 66% for osteomyelitis, a specificity of 85%, and should be should be included in the initial assessment of all diabetic patients with infected pedal ulcers. Incorrect Answers: Answer 1: Ray resection or partial foot amputation could be considered in this case, however this is usually reserved for patients who have failed local treatment or are systemically ill from their ulcer. Answer 2 & 3: Oral antibiotics or boot application are not an aggressive enough treatment option in this clinical scenario, and are more appropriate treatment options for Wagner grade 1 ulcers. Answer 5: Local debridement is more appropriate prior to moving forward with a transmet amputation
1.8
(98)
Please Login to add comment