رجل عمره ٦٢ سنة سكري بعد بتر تحت الركبة بثلاثة أيام، الجرح صار أحمر ومتورماً وفيه إفراز صديدي، والحرارة ٣٨٫٦، والنبض ١٠٨، والسكر ٣٢٠. ما الإجراء؟

A 62-year-old with diabetes 3 days after below-knee amputation has a red, swollen wound with purulent discharge, T 38.6 °C, HR 108 and glucose 320 mg/dL. What is done?

1. Stop insulin because of the fever
2. Cover the wound and ignore the fever
3. Massage the stump to improve blood flow
4. Notify, culture and start antibiotics

Answer: D) Notify, culture and start antibiotics. Wound infection signs with fever and hyperglycaemia after amputation need escalation, culture, antibiotics, glucose control and sometimes debridement.