Diabetic Foot Ulcer

Ulcerated 3

Step 1: View clinicals

A 57 year old man presents with a painless ulcer of the left foot, which occurred after an episode of minor trauma 3 months ago. He was diagnosed with type 2 diabetes 5 years ago, for which he is on maximum doses of Metformin and Gliclazide. An HbA1c performed 2 weeks ago was 9.9%

Step 2: Order all relevant investigations

Monofilament test

Five sites are tested per foot - all of them are negative for sensation.

Handheld Doppler Lower Limbs

All peripheral pulses are present.

X-Ray L/foot

The x-ray appears normal, with no evidence of osteomyelitis.

Wound swab + culture

Cultures are positive for Staphylococcus epidermidis.

Step 3: Select appropriate management

Wound Debridement
Saline dressings
Pressure stockings

Score: ★★☆