Plastic Surgery

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    • Breakdown of skin. Can be chronic and not healing.
    • Generally treat based on source.
      • If arterial insufficiency: (Arterial ulcers are distal between toes etc..)
        • If macrovascular: do arterial bypass surgery, etc..?
        • If microvascular (i.e. diabetes): control sugars
      • If venous insufficiency: need compression stockings etc..  (Venous ulcers around ankle)
    • Diabetic ulcers can be infected.  Typically can have anaerobics or mixed aerobics in addition to general Staph and Strep.
      • Keflex 500 qid x10days, can add metronidazole for atypical organisms due to diabetes.
      • Anther optino is amox clav.
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