18.9
Tropical Ulcer
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 18, Skin Conditions.
Clinical Description
Painful rapidly enlarging ulcers usually on the lower limbs of individual living in hot, humid, tropical regions
Signs and Symptoms
- Painful ulcers which enlarge rapidly
Treatment
- Improve nutrition and diet
- Clean ulcer with Hydrogen peroxide 3% solution 12 hourly for two weeks
Alternatively
- Wash with Potassium permanganate soaks 1ml in 10,000mls of water
- Debride the wound if necrotic
- Daily Potassium permanganate soaks or cleaning
- Dress the wound with Zinc paste with sulphur regularly till healed
- Rest with leg elevated
- Do a skin graft if wound is clean and shows granulation
If local infection presents:
- Give Amoxicillin 500mg PO 8 hourly for 7 days or
- Erythromycin 500mg PO 6 hourly for 7 days
- Children; Erythromycin 12.5 mg/kg body weight in 4 divided doses
- If possible, carry out culture and sensitivity testing to determine suitable antibiotic therapy
- Refer the patient to the hospital
Check doses against the printed guideline and your clinical judgement before treating a patient. Spotted an error? Report it from the contact links below.
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