What is the best wound care for a necrotic diabetic foot ulcer?

Team approach. Depends on what is meant by necrotic. Is there blood flow to the extremity or wound? If not, a vascular or interventional cardiologist need to increase the blood flow to the extremity. A podiatrist is needed to get any bony prominence resected and to offlaod the wound. An endocrinologist is needed to get the diabetes under control if out of control.
Multiple factors. It’s changing every day. Wound care requires multi-discipline input for proper wound healing. There are multiple modalities and multiple strategies to get a wound closed but it takes a knowledgeable well trained specialist to know when to implement the appropriate treatment during the course of wound healing using evidence based medicine.
Wound Care Center. If you suffer from any diabetic foot wound you need to see help with a certified wound care specialist and podiatric surgeon. Wound care centers specialize in treating all kinds of complicated diabertic and non diabetic wounds. If you are suffering with a necrotic wound seek medical attention, dont delay becuase a wound untreated can lead to limb loss.
Diabetic foot. You need to seek care from wound center or podiatrist as soon as possible. The evaluation of a diabetic foot ulcer requires a careful history, investigation of your neurological status of your feet, an assessment of the blood flow, and a comprehensive treatment plan that may include debridement, cultures, offloading (which is the most important issue most of the time), and testing. Do not delay!
See a professional. Successful treatment of diabetic foot ulcers consists of addressing these three basic issues: debridement, offloading, and infection control. Seek professional assistance.
Maggot therapy. If the wound is necrotic this needs to be removed. Apply maggots to debride the wound. Must make sure the blood supply is adequate for healing. Need to off load the wound. See a wound care specialist.
Medical care. Best care would imply you are seeing the appropriate people to best deal with this condition. A team approach responsible for keeping your sugar under control, making sure your bloodflow is adequate, offloading the foot if the ulcer is on the bottom of the foot and taking care of all other comornidities. This is not something to do without proper medical attention.
Depends on Bloodflow. If the skin around necrotic area is still healthy only a small portion is necrotic then you can start locally the first week with antibiotic cream to reduce bioburden and keep using local debridement - removedead tissue off the wound site and try to heal the area. Diabetic ulcers respond to oral vitamin k2 - you can read http://vitamink2.Org. I use 10% Phenytoin cream locally http://drbrown.Us.

Related Questions

What is the best way to change dressing diabetic foot ulcer after debridement? Changing dressing should be clean or sterile?

As clean as possible. If the packages are sterile inside, they need to be opened without touching the contents that comes in contact with the wound. Read more...
Follow your doc's. Instruction . The dressing should be adhered to according to your foot doctor or wound management specialist's instruction. Any suggestion from us would be really confusing . Diabetic foot ulcer is serious condition that requires thorough and diligent management . Follow your podiatrist's recommendation and instruction . Read more...
Sterile. Preferably sterile to minimize risk of infection. Read more...

How is a diabetic foot ulcer best treated?

Depends on site. This is dependent on many factors: locations, depth, involvement of deeper structures, underlying deformity, present medical status, actual cause (not all ulcers in diabetics are diabetic related) and compliance of the patient. Read more...
Multiple remedies. Wound care requires multi-discipline input for proper wound healing. There are multiple modalities and multiple strategies to get a wound closed but it takes a knowledgeable well trained specialist to know when to implement the appropriate treatment during the course of wound healing using evidenced based medicine. Read more...
Special care. Offloading of diabetic foot ulcers, good nutrition, glycemic control, regular wound debridement by your physician, and local wound care are essential for wound healing. Read more...
Wound care. . Diabetic ulcers will generally heal if you offload the area (decrease direct pressure with an insert, or a wheelchair), have your doctor trim the callus and dead tissue away on a regular basis, and if the ulcer is infected, you may need oral or IV antibiotics, depending on the severity of the infection. Read more...
Dfu. Cannot answer directly as these need to be seen. A well-trained clinician will take a history, evaluate, consider the factors of the diabetic control, the depth and status of the wound (Wagner Stage), infectious considerations, vascular status (clinical and testing), and then push for redistribution of pressure, ideally with a total contact cast. Read more...
4. 1. Keep weight off the foot. 2. Control diabetes. 3. Don't smoke. 4. See a podiatrist. Read more...

I have pad and a diabetic foot ulcer, I have been taking percocet 10mg/325. What else can I do to help?

Doctors. You should be working with your primary care physician to maximize blood sugar control and also seeing a podiatrist for treatment if the ulcer. He may also refer you to a vascular surgeon to improve circulation to the legs and feet. These doctors can also discuss methods of pain control and wound care. Read more...
Neuropathy? It's is also common to have a peripheral neuropathy with diabetic foot ulcers. This could be the cause of your pain and there are neuropathy pain medications that help. Another more limb threatening cause could be from "rest pain". This means your limb isn't getting enough blood supply. A vascular surgeon could help determine its cause. Read more...
Wound care. . Diabetic ulcers will generally heal if you offload the area (decrease direct pressure with an insert, or a wheelchair), have your doctor trim the callus and dead tissue away on a regular basis, and if the ulcer is infected, you may need oral or IV antibiotics, depending on the severity of the infection. The Percocet is only for pain, it will not help to heal the ulcer. Read more...
Special Care. Offloading of diabetic foot ulcers, good nutrition, glycemic control, regular wound debridement by your physician, and local wound care are essential factors in improving the potential for wound healing. Read more...
TEAM APPROACH. Taking an opioid makes me think the PAD is severe and the cause of the pain. You need a team approach with your PCP, podiatrist well versed in wound care or a wound care clinic and vascular surgeon. Read more...

I have pad and a diabetic foot ulcer, I have been taking percocet 10mg/325 but it does not relieve the pain very long, what type of pain medication and how many mg will help me stay pain free through the day?

Nothing. You need to get the blood vessels open and circulating blood to the areas that are lacking blood and are anoxic and ulcerated. Try nattokinase 3 pills 2 times a day taken on an empty stomach . See a doctor who does chelation therapy to clear the toxins in your body and restore circulation. Then the pain may go away without the narcotics. Read more...
Need further workup. The Percocet will not fix the problem, it just masks the pain. First, you need a full workup to make sure you do not have an underlying infection (maybe even of the bone). If the pain is coming from infection, then antibiotics will help resolve the pain. Second, you need a thorough work up of your circulation to make sure it is adequate, if not vascular intervention may resolve the pain. Read more...
Serious problem. You have a serious problem my friend. It is bad enough to have diabetes with a foot ulcer. And now you have pad. That pain you feel is from the pad. There may be no amount of pain medication that will relieve your pain. The pain is from a lack of oxygen to your foot. This needs to be evaluated and perhaps corrected asap by a vascular surgeon. It will help the pain and help you heal. Read more...

Can a silver sulphadiazine topical be used for a diabetic foot ulcer?

Silver dressings. Yes, this medication is a safe prescription medication used as one of an armamentarium in treating a diabetic foot ulcer. All foot ulcers should be seen by a health care professional as the consequences of a self-treatment failure can be muscle, tendon or bone infection; amputation; hospitalization; or sepsis and death. Do treat this condition by yourself! Read more...
Yes. As long as you don't have any allergies to sulfa medications or silver. Read more...
Yes. Some use this type of cream under certain circumstances. Different types of creams are available depending on the needs of the wound. Read more...

Are there any sprays or creams I can use to cure a diabetic foot ulcer?

No. There is no spray or cream that will cure an ulcer. The cause of ulcer must be determined, whether it is circulatory, excessive pressure, infection etc. Read more...
Yes and no. Offloading of diabetic foot ulcers, good nutrition, blood sugar control, regular wound debridement by your physician, and local wound care are essential for wound healing. There are many types of topical creams or ointment that can be of benefit under certain circumstances depending on the type and condition of the ulcer. Read more...
Diabetic foot. You need to seek care from wound center or podiatrist as soon as possible. The evaluation of a diabetic foot ulcer requires a careful history, investigation of your neurological status of your feet, an assessment of the blood flow, and a comprehensive treatment plan that may include debridement, cultures, offloading (which is the most important issue most of the time), and testing. Do not delay! Read more...

How bad is it to wet diabetic foot ulcer bandage in the tub or shower?

Not bad. If you have an ulcer it is quite alright and recommended to let the ulcer get wet in the shower as long as it is dried and properly dressed after the shower. This will help keep the wound clean. Read more...
May not be good. Notify your doctor to see if bandage needs to be changed. You don't want to increase the chance of infection. Read more...
Follow Recs. The dressing of a foot ulcer and the ulcer of any type (diabetic, venous, arterial) should not be allowed to get wet in the bath. You should call your wound care provider's and request their instruction. Read more...
Keep it dry. You never want a wet bandage to remain on a wound--it can cause skin breakdown or allow infection, and can make the wound bigger. If the dressing gets wet, it needs to be changed, especially if using a prescription cream or wound care product. Best thing to do is make sure it doesn't get wet in the first place! Read more...
Wet bandages. Wet bandages are not good for healing as they increase the moisture on the skin and surround tissue around the wound. This causes maceration. Think of a brick wall: the moisture destroys the mortar inbetween the bricks making the cells [the skin] unstable. Remove and seek gudiance from the group who are follwoing your wounds. Read more...