A surgeon is providing care for a 75-year-old patient suffering from Type II diabetes with a non-healing, infected laceration on his leg. Their leg is covered with thick, leathery, black tissue and some yellowish discharge. What might be a reasonable course of action by the surgeon in the initial treatment of the patient?

• A. Frozen section
• B. Debridement 
• C. Exfoliation 
• D. Fungal scrapings

Answer: (B)

Verified step by step guidance

1. Step 1: Understand the clinical presentation described: a 75-year-old patient with Type II diabetes has a non-healing, infected leg laceration covered with thick, leathery, black tissue and yellowish discharge. This suggests the presence of necrotic (dead) tissue and infection.
2. Step 2: Recognize that in diabetic patients, wounds with black, leathery tissue often indicate necrosis or gangrene, which can impede healing and promote infection.
3. Step 3: Identify the primary goal of initial treatment, which is to remove the necrotic tissue to prevent further infection and promote healing. This process is called debridement.
4. Step 4: Understand that other options like frozen section (a rapid biopsy technique), exfoliation (removal of superficial skin layers), or fungal scrapings (testing for fungal infection) are not the immediate priority in this scenario because the main issue is necrotic tissue and infection.
5. Step 5: Conclude that the reasonable initial surgical action is to perform debridement to remove the dead tissue and control infection, thereby preparing the wound for further healing and treatment.