Hi, thanks for posting your concern in the HCM. The initial collection of fluid and blood in your local
soft tissue will gradually get absorbed with time. You may also notice a colour change in the bruised area because that is the natural way of progression of a bruised wound. But, the thing that produces the concern here is the soreness of the lump and persistence of the bruise. A diabetic patient often have micro and macrovascular complications of
diabetes. These in the extremities are often aggravated by precipitation of neuropathy causing altered sensation locally. From the history, i can see that you have a very high BMI which is also not good for a known diabetic. So, my recommendations are-
1. Urgent local examination by a
general surgeon to rule out
diabetic foot.
2. Strict control of diabetes- Dietary modifications are definitely needed alongwith daily exercise (but you should put stress on the affected limb only after it is cured)
3. Elevation of the affected limb and local care
4. A
complete blood count and CRP, fasting plasma glucose and HBA1c should be done.
5. Antibiotics may be started after consulting your surgeon or an infectious disease specialist. Diabetic foot may be complicated by
cellulitis to
chronic osteomyelitis. In the worst situation gangrene may develop. Easiest infections are usually treated with co-amoxyclav or cephalosporins while more aggressive antibiotic treatment may be needed in complicated situations.
6. Necessity of surgical debridement will be assessed by your surgeon too to remove the dead tissues and infective focus.
For any further query please write back to the HCM. Best Wishes. Dr. Kaushik