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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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On Insulin For Diabetes. Prescribed Sefix CV For Foot Ulcer, ESR 126, Uncovered Skin On Foot. Advice

Hi good morning Dr.
My mom is diabetic and is on insulin. She had a foot ulcer 2.5 months back and still the skin has not covered. The skin is not growing. She was prescribed Sefix CV for 2.5 months but still her ESR is 126. She doesn't have any pain or inflammation anywhere except in her foot where the wound is. What should be done for skin growth and why is her ESR very high? Pls looking forward to ur reply.
Thu, 4 Jul 2013
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Internal Medicine Specialist,  's  Response
Hi,
Thanks for using Healthcaremagic,
Your mother id diabetic and having foot ulcer for 2.5 month it is non healing with loss of skin.
Only taking antibiotics may not be enough, Proper assessment and management of diabetes-related foot ulcers is essential to reduce amputation risk. ESR may be high due to chronic inflammation and infection.
Proper dressings, surgery debridement, pressure off loading, if bones are involved that is osteomyelitis, and vascular management if blood supply is compromised.
Very good blood sugar control to help in other words multidisciplinary approach is required and a plastic surgery requiring skin grafting may be answer.
So apart from Endocrinologist please consult a Plastic surgeon.
Hope this helps.
Take care.
Good Luck.
Dr.Akhilesh Dubey M.D.

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General & Family Physician,  Dr. Athish Peter Margos R's  Response
Hello,
Healing is delayed in diabetes due to various reasons including metabolic,infective etc.Healing process is abnormal.To overcome these barriers is difficult in most cases.Sefix CV is an antibiotic to prevent infection, which is very common in diabetic ulcer.Skin growth will be slow.Firstly it requires very good sugar level control.Regular clean dressings are mandatory.Biologic dressings may be more helpful.Protein enzymes may be taken in tablet form,which would help in tissue growth.
Regarding ESR it is a very non specific test.Too many causes lead to its rise.Hence just ESR monitoring does not help much and it would be advisable to not look deeply into it.
Wishing your mother a speedy recovery.
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On Insulin For Diabetes. Prescribed Sefix CV For Foot Ulcer, ESR 126, Uncovered Skin On Foot. Advice

Hi, Thanks for using Healthcaremagic, Your mother id diabetic and having foot ulcer for 2.5 month it is non healing with loss of skin. Only taking antibiotics may not be enough, Proper assessment and management of diabetes-related foot ulcers is essential to reduce amputation risk. ESR may be high due to chronic inflammation and infection. Proper dressings, surgery debridement, pressure off loading, if bones are involved that is osteomyelitis, and vascular management if blood supply is compromised. Very good blood sugar control to help in other words multidisciplinary approach is required and a plastic surgery requiring skin grafting may be answer. So apart from Endocrinologist please consult a Plastic surgeon. Hope this helps. Take care. Good Luck. Dr.Akhilesh Dubey M.D.