Pathophysiology, Etiology, And Risk Factors Of Diabetic Foot Ulcers

Jane presented with a wound to her lower left leg which, following a holistic assessment (appendix 2), was diagnosed as a venous leg ulcer. The assessment was conducted in accordance with Local PCT Leg Ulcer Guidelines (appendix 3) as well as RCN Guidelines (RCN 2006) to rule out other possible aetiology such as arterial ulceration, diabetes or malignancy (Moloney and Grace 2004). Although traditionally considered uncommon, recent studies suggest that malignant ulcers are more prevalent than previously thought (Miller et al 2003, Taylor 1998) therefore even though initial assessment suggests an uncomplicated venous ulcer, if Jane’s wound fails to heal following appropriate treatment then specialist advice will be sought. Between 17% and 65% of people with a leg ulcer experience severe or continuous pain with a major impact on quality of life (Briggs and Nelson, 2003) and effective pain relief is important to maximise quality of life, to enable mobilisation and improve appetite to facilitate wound healing. Fortunately, Jane experienced no pain from the leg ulcer prior to or at the time of assessment. However, careful review and monitoring of any pain will be important throughout the treatment process as the first line of treatment for uncomplicated venous leg ulcers are compression systems (RCN 2006) and although compression counteracts the harmful effects of venous hypertension and

The goal to treat an ulcer in a diabetic patient is to heal the wound faster to prevent infection, pressure has to be take off the area by “offloading” the foot, remove dead tissue by the process of debridement, apply to dress per doctors order, and focus on managing the patient’s blood sugar effectively to promote healing. In addition, to prevent infection, the patient must keep the dressing clean, cleanse the wound daily and change the bandage and dressing, the patient must also avoid walking on barefoot.

Living with annoying venous painful wound leg ulcers is so miserable, it seems it would be endless, leads you wanting to be alone and having unwanted life. In spite of current mountainous researches work in the management of this type of wound, still the problem persisted and continuously affecting certain populations. Venous legs ulcer has great impact in life; physically, mentally and psychosocially.

Foot ulceration is common, affecting up to 25% of patients with diabetes during their lifetime. Over 85% of lower limb amputations are preceded by foot ulcers and Diabetes remains a major cause of non-traumatic amputation across the world with rates being as much as 15 times higher than in the non-diabetic population. Prevention is the first step towards solving diabetic foot problems. Although it was estimated that an ankle is lost to diabetes somewhere in the world every 30 seconds, a more important fact is that up to 85% of all amputations in diabetes should be preventable. Strategies aimed at preventing foot ulcers are cost-effective and can even be cost-saving if increase education and effort are focused on those patients with recognized

The goal in nursing is that we must prevent these types of patients, from being readmitted into the hospital. We need to focus on ways to help these patients manage their leg ulcers at home with the proper support and follow up care and by addressing the psychological effect of the leg ulcers it may help these patients with their self-esteem and body image.

Therefore, the aim of this literature review is to explore issues in relation to patient concordance in their leg ulcer care in the

Diabetes affects every system in the body, including the nervous and circulatory system, and immune system. Dysfunction in these three systems set up a catch-22 situation that can have serious consequences. A diabetic may have neuropathy, or nerve death in the feet. This means that your feet are not very sensitive, and he may not notice if he has stepped on something sharp, or have an ulcer on the foot. Poor circulation means he does not have enough blood to help the wound heal, and if infection sets in the wound, can

Pressure ulcers remain an issue in nursing, as they cause financial losses to not only the patients, but also the healthcare sector. In addition, the expenses arising from extended hospital stays, an increase in readmissions, and admissions to the hospital are included as well. Over the years, preventive interventions have focused on the elimination of pressure ulcers. In such cases, the prevention strategies have concentrated on the role of nurses in preventing the occurrence of pressure ulcers. Current texts reveal strategies that can be implemented in order to effectively manage and prevent pressure ulcers in the healthcare sector. The use of a proficient wound care team is common in many skilled nursing facilities. The failure for the effective management of this ulcer demonstrates a need for the adoption of new beneficial strategies. While previous researchers have proposed investigations on the effectiveness of a wound care team in the management of a pressure ulcer patient, the gap between writings and implementation still persists. Nurses have a role in presenting a plan that will encourage effective prevention and management of

A nursing diagnosis specific to the patient would be at risk for infection related to impaired skin integrity as evidence by ulcer on foot. It is important that the client understand that wearing heels increases the risk of infection. The client states “I like to wear heels” shows her knowledge about wound care is not met. Tight fitting shoes can generate an ulcer by rubbing on a part of the foot that has become numb as well as increase the risk of infection, prolong the duration, and increase depth of the ulcer. (“A nurse’s guide,” 2015). It could even create new ulcers. Also, understanding that standing all day will cause the ulcer to heal slower and increase the risk of a possible infection which could potentially lead to more serve problems.

Indeed, this paper, after the overview given on diabetes, is really about diabetic foot ulcer as one of the prominent complications of uncontrolled diabetes. Diabetic foot is certainly one of the more serious complications in diabetes as it can turn from a minor manifestation to extremes such as amputation in a flash. The processes behind the formation and progress of it will be elaborated at a later part in this paper, as will the details of the teaching project behind this paper, in order to increase awareness about diabetic foot, its prevention and its management.

There are many issues in the clinical setting that nurses have to be aware of and be educated on preventing and treating. One of those issues that have to be addressed is pressure ulcers. Pressure ulcers can occur over the bony prominences where the body’s tissue has been pressed against for extended periods of time. There are certain factors that put a patient at risk for the development of these pressure ulcers and it’s the nurse’s responsibility to be aware of these risk factors. The most common places that a patient can develop these ulcers are ankles, sacrum and hips. Patients who have impaired mobility and those who aren’t able to ambulate have and increased risk for developing pressure ulcers.

Diabetic neuropathy is the most common factor in almost 90% of diabetic foot ulcers [9, 10]. Nerve damage in diabetes affects the motor, sensory, and autonomic fibers. In patients with peripheral diabetic neuropathy, loss of sensation in the feet can cause further damage such as repetitive minor injuries that are undetected at the time and may subsequently prompt foot ulceration. In addition, structural deformities and abnormalities of the foot further increase the risk of ulceration. Other risk factors include a previous history of foot ulceration or amputation, visual impairment, diabetic nephropathy, poor glycemic control, and cigarette smoking. This may increases the chance of infection to the ulcer. Lack of wound healing, systemic sepsis,

Literature reviews provide nurses with “critically appraised and scientifically proven evidence for delivering safe quality care” (Majid, Foo, Luyt, Zhang, Theng, Chang & Mokhtar, 2011, p. 229). Use of the evidenced-based information found in the literature review provided the writer with information to change clinical practice. It was evident that a foot check program was needed in the writer’s hemodialysis unit to prevent foot complications because of the high incidence of diabetes and peripheral vascular disease. There were many literature reviews read in preparation for planning a foot check program. According to Jones, Crawley, Phillips & Riley (2013) all hemodialysis patients must be considered at high risk for foot ulceration. It was

Generally our population sees diabetes as a disease for people that can’t eat sugar, but, those with diabetes know it comes with some life changing events. Diabetes effects an estimated 29.1 million Americans each day. Diabetes develops in one of two forms, Type one and Type two. Type one is insulin dependent diabetes, where the body lacks production of insulin (Ignatavicius & Workman, 2013). Type two diabetics are insulin resistant, affecting mostly adults (Ignatavicius & Workman, 2013). Diabetes is a chronic illness that accounts for many comorbidities and complications to those suffering from the disease. Diabetes is the seventh leading cause of death from conditions including, hypertension, dyslipidemia, cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and amputations (American Diabetes Association, 2016). Management of these complications can occur with proper education, health promotion, and prevention from the patient. Foot care and ulcer prevention can reduce or eliminate complications suffered by diabetics; leading to infections requiring hospitalization and the most serious amputations. Teaching this population or any population about their healthcare needs and requirements can be difficult. Establishing the best way to education will be explored within this paper. Throughout this paper the author will take a look at daily foot care and prevention of ulcers. The paper will

Research question: What are the contributing factors in developing a diabetic foot ulcer in Type 2 diabetics in the community?