Diabetic Wound Healing Potential Of Ncs : Case Study

Wound management is one of the cornerstones for nursing care however, effective wound care extends far beyond the application of the wound itself. Nurses may be required to assess, plan, implement, and evaluate wound care; therefore, order to fill these roles it’s critical to have an understanding of the several different areas of wound care such as, integumentary system, classification of wounds, wound procedures, and documentation. Knowledge in each of these areas will allow nurses to make well informed decisions about wound care, and as a result play an active part in wound healing.

Stechmiller, J. K. (2010). Understanding the Role of Nutrition and Wound Healing. Nutrition in Clinical Practice, 25(1), 61-68. doi:10.1177/0884533609358997

Water uptake capacity of NCs enables them to entrap exudates upon contact with suppurating wounds which is desirable for their effectiveness as wound dressings. The increase in size and agglomeration of AgNPs from NC-1 to NC-3 might have resulted in more blockages of pores of CNCs which could be responsible for a decrease in water uptake capacity of NC-2 and NC-3 as compared to NC-1.

Integra is a synthetic wound dressing frequently used to treat burn wounds (Figure 5). It is a bilayer composed of bovine tendon collagen glycosaminoglycan (chondroitin-6-sulphate) cross-linked to it, onto which a silicone (synthetic polysiloxane polymer) membrane is sealed to the upper surface to act as a protective temporary epidermis. The silicone layer is applied as a liquid monomer; curing occurs on the surface of the collagen at room temperature. It serves to control moisture loss from the wound. Water flux across this silicone membrane is the same as that across normal epidermis. The collagen-GAG matrix contains pores ranging from 70 to 200 µm that are invaded by host fibroblasts upon application to an excised wound bed. The pore size was carefully designed by adjusting the collagen-GAG mixture. In GAG-free collagen, the resulting structure was more closed than in collagen-GAG matrices. Smaller pores can delay, or even prevent, biointegration, whereas larger pores would provide an insufficient attachment area for invading host cells. Freeze-drying procedures followed by slow sublimation are used to control pore size too. The degradation rate of 30 days of the collagen-GAG sponge is controlled by glutaraldehyde-induced cross-links. The polypeptide collagen is used for its low levels of antigenicity (it has minimal rejection potential) and because it exerts a hemostatic effect on vascular wounds. Collagen is already found in skin. It is degraded by collagenase deposited

Patients at Long Term Care Facilities are generally debilitated and elderly people who have incontinence problems. Incontinence makes treating pressure ulcers very difficult because it alters tissue tolerance and reapplying products becomes very costly. Usually negative pressure wound therapy (NPWT) is used to treat pressure ulcers but it is also very costly and does not match with some wound locations. Collagen plays a vital role in the wound healing process by creating a framework for the adhesion, movement, and production of new cells. This study determined the effects and uses of Type 1 formulated collagen on granulation tissue formation and reepithreelialization in chronic pressure ulcers.

Today, despite precise surgical techniques to cut out dying tissue, artificial skin and other high-tech treatments, hard-to-heal wounds remain a huge problem. Diabetic foot ulcers alone strike about 600,000 people annually and lead to thousands of

Wound healing also demands high energy needs of the patient. An increase in metabolic need causes an increase in demand for glucose, which is the major fuel source for collagen synthesis and the most efficient source of fuel for adenosine triphosphate synthesis compared with fat (Timms, 2011).

The clinical issue to be explored is the use of negative pressure wound therapy (NPWT) in the treatment of ulcers. A valuable journal containing articles pertaining to this topic is the International Wound Journal. It is a peer-reviewed journal used by various healthcare providers, including nurses, doctors, podiatrists, surgeons and others, seeking to gain up-to-date information on the prevention and treatment of wounds (Wiley Online Library). It has aided in enhancing the standards provided in wound care by health care professionals. Examples of subject matters covered are diabetic wounds, burn wounds, scar prevention and treatment, wound healing therapies, education and training and more (Wound Source). The journal is therefore

Harper, Young, and McNaught, (2014) explain the four distinct phases of wound healing that are identified as hemostasis, inflammation, proliferation and tissue remodeling. Hemostasis is the body’s response to prevent exsanguinations; thusly, the cascading response to injury causes constriction of blood vessels but if continued, leads to tissue hypoxia and acidosis. The next stage of healing is inflammation. This stage is a result of cells that inhibit and prevent infection and once the resulting threat of infection is gone, inflammation will subside. Prolonged inflammation can lead to chronic wound formation. The next stage of healing is proliferation which consists of angiogenesis, formation of granulation tissue, collagen deposition, epitheliazation and wound retraction. It is during this stage the extracellular matrix is laid down forming

At 6 hours, the wound closure in the control (Fig. 1a), diabetic (Fig. 1c) and diabetic groups supplemented with whey protein (Fig. 1e) was not visible. In contrast, wound closure in the diabetic rats supplemented with whey protein at 4 days after the injury (Fig. 1f) was greater than the diabetic rats (Fig. 1d) and nearly similar to the control rats (Fig. 1f).

Diabetes has several negative effects on the body. Diabetes can effect wound healing, infection, and weight. When it comes to diabetes, many factors play a role in the reasons why wound healing takes place slowly. The most evident factor, and the root of most of the other factors, is high blood sugar levels. The high blood sugar levels lead to artery stiffness and vessel narrowing. Being that the vessels are narrowed, blood circulation will be very poor. Blood circulation involves red blood cells and white blood cells. If the circulation is poor, white blood cell will not be able to be as affective when fighting off pathogens. Another problem is diabetic neuropathy, and this is basically when those with diabetes loose feeling sensations because

Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus [2]. Non-healing ulceration usually progress to amputation in spite of standard care. DFUs result from interaction of ;neuropathy, peripheral vascular disease and foot deformity. 80% of diabetic persons with foot ulcers present with peripheral neuropathy which is the greatest risk of foot ulceration [3]. Neuropathy in DM shows variable degrees of autonomic, sensory, and motor functions changes[4]. Motor neuropathy causes atrophy of the foot muscles resulting in clawing of the toes, sensory neuropathy results in repetitive trauma to the foot, and autonomic neuropathy changes skin consistency so accelerating ulcer formation [5] .40 to 50% of all patients show ischemic manifestations with the most having neuroischemic ulcers, and only few of them has purely ischemic

Neutrophils start with the critical task of destroying and removing bacteria, foreign particles and any remaining damaged tissue. This phagocytic activity is crucial as bacterial imbalance within acute wounds causes the wound to stop healing. Neutrophils are attracted to the site of injury within 24 – 36 hours by pro-inflammatory cytokines including TGF- β. Neutrophils are one of the most abundant cells of the immune system and they are extremely active during the repair of cutaneous wounds. In general, the antimicrobial

The management of diabetic foot ulcers remains a major therapeutic challenge, which implies an urgent need to review strategies and treatments in order to achieve the goals and reduce the burden of care in an efficient and cost-effective way. Questions remain as to which types of intervention, technology, and dressing are suitable to promote healing, and whether all therapies are necessary and cost-effective as adjunctive therapies. Prevention of diabetic foot ulceration is critical in order to reduce the associated high morbidity and mortality rates, and the danger of amputation. It is essential to identify the “foot at risk,” through careful inspection and physical examination of the foot followed by neuropathy and vascular tests. Regular

The majority of arterial leg ulcers will heal over time if the root cause is managed such as recovery from trauma or restoring sufficient blood flow to the affected limb(s) (Wilkinson, 2014) (Forster & Pagnamenta, 2015). Arterial ulcers, depending on the symptoms and the aim of the treatment, different dressings and topical agents are used to provide an optimal healing environment for the ulcer. In a review of different studies examining the effects on healing dressings or topical agents have on arterial ulcers, it was found while a ketanserin ointment group showed improved healing there is yet to be sufficient sample sizes and supporting evidence to conclude if the choice of a dressing or topical agent affects the healing process (Forster