4 Days Of Worsening in Surgery — 62yo Man | General Surgery | SMLE Q#11245
SMLE Question #11245
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 62-year-old man with poorly controlled type 2 diabetes presents with 4 days of worsening pain and malodorous discharge from a plantar right-foot ulcer and difficulty walking. Examination shows a 4 × 5 cm ulcer with necrotic tissue, purulent discharge, surrounding erythema, and tenderness; dorsalis pedis and posterior tibial pulses are palpable. Plain foot radiograph shows no soft-tissue gas and no bony destruction. What is the most appropriate next step in local management of this wound?
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