Science & Engineering

How to treat/cure/handle, Gangrene accompanied with Cellulitis in Diabetic Patients

Gangrene is a serious and potentially life-threatening condition that arises when a considerable mass of body tissue dies (necrosis).[1][2] This may occur after an injury or infection, or in people suffering from any chronic health problem affecting blood circulation.[2] The primary cause of gangrene is reduced blood supply to the affected tissues, which results in cell death.[3] Diabetes and long-term smoking increase the risk of suffering from gangrene.

Gangrene is a medical term used to describe the death of an area of the body. It develops when the blood supply is cut off to the affected part as a result of various processes, such as infection, vascular (pertaining to blood vessels) disease, or trauma. Gangrene can involve any part of the body; the most common sites include the toes, fingers, feet, and hands.

How to identify Gangrene accompanied with Cellulitis in Diabetic patients?

The symptoms may include a small open/closed wound with/without pain.  Over time, the area around the wound becomes reddish, starts change of skin color to brown/black, the portion of the infection keeps increasing despite use of antibiotics.

 

How to Diagnose Gangrene accompanied with Cellulitis in Diabetic patients?

Check for any abnormality in blood RBS, CBP, ESR, CRP, S. Creatine, SGPT.  Verify the the glucose levels in urine as well.

A Sugar (RBS) level test of both Blood and Urine during both Pre-prandial (Early morning with empty stomach) – Postprandial (2 hrs after having lunch).  The ideal values are: Pre-prandial should be 70-130 mg/dl  and Postprandial should below 180 mg/dl.

The Total WBC cell count and further to that check the Neutrophils count indicates the severity of the infection. Neutrophils are the first immune cells to arrive at a site of infection, through a process known as chemotaxis. Neutrophils are the most common type of white blood cell, comprising about 50-70% of all white blood cells. They are phagocytic, meaning that they can ingest/eat other cells, though they do not survive the act.

The excessive presence of the Neutrophils in the form of inflammation is called Cellulitis.  Cellulitis is a spreading bacterial infection of the skin and tissues beneath the skin. Cellulitis is caused by a type of bacteria entering the skin, usually by way of a cut, abrasion, or break in the skin. This break does not need to be visible.

 

When the skin changes to dark black but doesn’t respond or recover after using antibiotics for a longer portion indicates Gangrene. At which point a doctor may opt for surgical treatment to stop the Gangrene from spreading.

 

Medical treatment for Gangrene accompanied with Cellulitis in Diabetic patients?

Injection: to be given IntraVenous (directly into the nerve):  AUGMENTIN 1.2 grams

Drug combination is: Amoxicillin Sodium (1060 mg) and Potassium Clavulanate (238 mg)

Dosage: Daily twice  (For #5 days or upto a week)

Pain reliever: Movon-P (Aceclofenac + Paracetamol)

 

If no improvement add below Injections:

INJ: AUGMENTIN 1.2 grams (Amoxicillin Sodium and Potassium Clavulanate)

INJ: Metrogyl (Metronidazole) 500 mg Daily thrice

INJ: Pan IV (Pantoprazole) 40 mg Daily Once

TAB: Chymonac (Aceclofenac + Paracetamol + Chymotrypsin) Daily Twice

 

To Control Diabetes use below medicine:

Diaonil 5 mg (twice a day), if no improvement: use Glucored (twice a day)

Insulin injection direct, before dinner

 

Treatment after surgery:

INJ: Taxim – 1 g Inj Daily twice

INJ: Amikacin 500 mg Daily twice

INJ: Metrogyl (Metronidazole) 500 mg Daily thrice

INJ: Pan IV (Pantoprazole) 40 mg Daily Once

INJ: Voveran Ample Daily Once after dressing

TAB: Chymonac (Aceclofenac + Paracetamol + Chymotrypsin) Daily Twice

Dressing of the surgery location for alternate dressing to clean up everyday

 

Treatment the surgery location: Dressing Set includes

Sterile Combine Dressing Pads (20cm x 10 cm)

Gauge bandage (10 cm x 3m)

Big Cotton Roll

Medical Plaster big size

T-Bact Ointment (MUPIROCIN ointment USP)

Betadine Microbicidal solution (Povidone-Iodine Solution IP)

Hydrogen Peroxide big bottle

 

 

Treatment for Discharge:

INJ: Amikacin 500 mg Daily twice (ALFAKIM by Ranbaxy)  + Disposable Syringe 2 ml + One I V CANNULA for injecting INJ directly into nerves

TAB:Taxim – O 200 mg  daily Twice

TAB:Pan 40 mg Daily Once

TAB:Metrogyl 500 mg

TAB: Chymonac (Aceclofenac + Paracetamol + Chymotrypsin) Daily Twice

Dressing of the surgery location for alternate dressing to clean up everyday

 

 

Diet to control/reverse Gangrene accompanied with Cellulitis in Diabetic patients?

Limit quantity of food and increase frequency of taking food

Take As much as Green Vegetables

Have Spinach, Cabbage, Cauliflower,

Avoid All sweet releasing items including fruit juices

Walk for sometime and check the movement of the body part supposed to be gangrene affected.

 

Food to take for patients suffering Gangrene with Cellulitis and have Diabetic:

 

 

 

 

References:

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