instruction: hi I might need a general surgeon for a consult regarding my mother wound she is 81 years old she is had it since end of last year she has seen doctors and has gone lab tests based on her lab results the first doctor up to the third has prescribed mupirocin ointment antibiotic which lasted to 20 days and mefanamic acid only if she feels pain unfortunately it has not gotten any better I hope someone can help thank you she used to have a wound on the same area when she was young between years old to 10 years old but it got better but now it is back
output: hello I will definitely help you regarding your mother problem I have seen the image and lab report of your mother there is a ulcer in her leg medial aspect as I can see it is a chronic non healing ulcer because the margins are sharp and base is filled by yellow debris in healing ulcer ulcers are sloppy and base is filled by healthy and red granulation tissue but in your mother case it is of non healing type there are many reasons for non healing ulcer like old age diabetes hypertension and immunodeficiency as your mother age is 81 year than it may be a probable cause because blood investigation seems to be normal one more thing I want to tell you that varicose veins are one cause that may present with this type of ulcer in medial side of leg exactly where this ulcer is located to confirm the diagnosis of varicose veins I need image of whole leg to see the dilated veins you may go through color doppler venous both leg to rule out varicose veins now the treatment part no role of antibiotics now as there is no active pus discharge one thing that can be done is scraping of the dead floor and margins of ulcer so healing will fasten it can be done by local surgeon also you can apply mupirocin ointment start vitamin tablet gram daily it enhances immunity and help in healing of ulcer hope it helps get back to me anytime