9698

  

Assessment:Left lower extremity, skin has large cobblestoned appearance with malodorous hyperkeratosis and 3 non pitting edema. Medial aspect off-white patch noted with live maggots, creamy scant thick drainage with foul odor. Multiple open ulcers noted.Right lower extremity, medial aspect skin has cobblestoned appearance with hyperkeratosis and 3 non pitting edema. No open ulcers noted.Bilateral feet toe nails long with onchomycosis. Treatment:Bilateral lower extremities were washed and scrubbed with chlorahexadine soap. Dakin’s solution 0.25 was used to cleansed the off-white patchy areas with maggots. Both legs were patted dry with a towel. Granulex spray Castrol oil, balsam, peru, trypsin compound was applied to both legs. Covered with EXU-DRY dressing and wrapped with three layer compression dressing Dyna wrap.Toe nails were also trimmed.