Wound on the right foot toe
 

Hi,

I am Amit from Mumbai. I am a Type 2 diabetic since 2007 and 40 years of age now. I weigh 95 kgs. I take following tablets

Morning :- Glimepiride 2mg and Metformin 850 mg and Pioglitazone 15mg.

Afternoon :- Metformin SR 1g.

Night :- Glimepiride 2mg and Metformin 850 mg.

I am checking my sugar by glucometer twice daily.It is always below 180.

I have a family history of diabetes. All my relatives have been Type 2 diabetics.

On 8th April,i.e. a a week back, I got a deep cut on my right toe bottom by dashing against a ceramic tile. The cut is where the thumb ends and there is fold of skin. The cut is deep. I am applying Neosporin ointment daily.

I dont want to take systemic antibiotics because I have already been taking for my teeth removal. It causes severe gastric problems.I may have to take,I dont know.

There is a flap of skin covering it completely from the bottom. Should I
scrape it out to make the wound open ? Please advise. Otherwise the
neosporin does not go inside the wound. I can apply it only on the flap of
skin.

I am also offloading my feet to take any pressure off. It has been seven
days - no signs of any healing.

I am really scared at the thought of amputation.Please advise.

Regards,
Amit.

You should get a doctor or nurse to help you dress that wound.
Clean it every day with hydrogen peroxide...which bubbles up and shows you by how much it bubbles, how dirty it is.

There are toe bandages, and a podiatrist could show you how to take care of it, so it won't get infected.

Type II patients don't get severe infections as often as type I patients. The length of time you have had type II is also a factor.

I use hydrogen peroxide on cuts etc. all the time.

Consider with all that metformin you use that you may need B12 supplements as well. Low B12 is common in India (due to diet), so you can get testing and proper oral dosing if you are becoming low. Metformin blocks B12 absorption, so do get that tested and squared away. You should be at 400pg/ml at least.

Hi,

I visited a podiatrist today.

The nurse scraped out dead skin and dressed the wound.

She asked me to take Ofloxacin 400 mg once daily though it is not infected.

She will dress it again the day after tomm. She used Betadine ointment on the wound.

Regards,
Amit.