An advantage of thinking more comprehensively about the pathogenic abnormalities that impair healing is that one can view existing therapies and procedures in a different light, and with different justifications. For example, the process of surgical debridement of diabetic foot ulcers becomes more than simply removing necrotic tissue; at the same time, one is also removing the excessive bacterial burden and, possibly, the phenotypically abnormal cells that may be present in and around the wound. Another example is the removal of edema, which is also critical in the management of diabetic ulcers. Edema removal decreases the chronic wound fluid that has been shown to be deleterious to resident cells and that may enhance bacterial colonization. Therefore, existing therapies can be integrated better with pathophysiological principles [68]. The risk factors like obesity and very high levels of blood glucose were found in our study which contributed to the formation of chronic wounds along with microvascular complications. The locations of ulcers were mostly on the lower limbs which can be due to poor hygiene and negligence of the wound treatment if formed. The patients also revealed the high levels of C reactive protein which can be said that there is high risk of ischemic foot leisions and amputations and clinical treatment failure in diabetic foot patients [69].
There was an increased serum creatinine levels in patients with chronic wounds which can be admitted to
Deficiencies in a persons diet can impede progression through the normal stages of wound healing. Malnutrition has also been related to an increase in infection rates. Jean understood this and assured me she would take this in to account to enable the healing process. Jean went on to explain that the injury was caused when somebody ran into her leg with a supermarket trolley. She had initially applied a dry dressing but attended her GP’s when the wound became wet and painful.
Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et
• Nutrition- Mani (2003) claims that nutrition is a fundamental role that must be adopted in the treatment and healing process of pressure ulcers. A balanced diet with adequate nutrients should be key for all patients deemed to be at risk of pressure ulcers. Both nutrition and hydration are the basic components in promoting wound healing and maintaining normal tissue integrity. Patients at risk of pressure ulcers should be nutritionally assessed at regular intervals (Shepard. 2003). This could have been adopted by the use of assessment tools such as, The Nutritional Screening initiative. This tool includes nutritional screening at regular intervals and a comprehensive assessment that includes nutritional assessment, functional assessment and evaluation for depression. This comprehensive approach allows the nurse to quantify the nutritional problems and initiate the appropriate resources that will meet with the individual needs (Bryant, 2000). Another optional tool is the Malnutrition Universal Screening Tool or MUST. This has been designed by the Malnutrition Advisory Group (MAG) of the British
People with diabetes also have a higher risk of developing foot ulcers that can take weeks or months to heal. Food choices and nutritional status influence wound healing since serious wounds increase the energy, vitamin, mineral and protein requirements necessary to promote healing. Most things can help your blood clot and you serious sores or cuts heal, When you have like a smell or oder example: a skunk you wash you body in tomato sauce to get the smell to fade away . When you want your teeth to grow strong or eyes to be clear you can eat certain thing to help them get stronger that's exactly how you can clear your skin from sores bumps and ect.
Stechmiller, J. K. (2010). Understanding the Role of Nutrition and Wound Healing. Nutrition in Clinical Practice, 25(1), 61-68. doi:10.1177/0884533609358997
On assessment, the wound was slightly exudates, odour, sloughs and dry skin patches on the surroundings. Sprakes (2010) state that, holistic assessment of patient and the wound are essential in order to facilitate the wound healing process. Ousey and McIntosh (2010) points out that, chronic wounds are exacerbated by a sequence of misdiagnosis, neglect, incompetence or inappropriate treatment strategies. I observed that, M’s wound was with exudates and sloughs; this
It is estimated that 387 million people, globally live with diabetes (Phillips & Mehl, 2015). According to Medical News Today [MNT], diabetes is a metabolic disorder; which causes patients to be extremely thirsty and produce a lot of urine. Diabetes arises due to high blood pressure, due to the body not being able to produce enough insulin or because the body does not respond well to high insulin levels (MNT, 2016). There are four types of diabetes; there is the pre-diabetic stage, type 1 diabetes, type 2 diabetes and gestational diabetes. In 2014, 29 million people died due to diabetes. This equates to 1 diabetic patient dying every seven seconds due to preventable complications (including complications affecting lower limbs) caused by diabetes. It is said that 20-40% of health care costs are spent on the treatment of lower limb complications due to diabetes. The risk of a diabetic patient developing a foot ulcer is 25% and foot ulcers account approximately 85% of lower limb amputations. Diabetic complications that affect lower limbs are caused by both type 1 and type 2 diabetes (Phillips & Mehl, 2015). It is said that the World Health Organization described diabetic foot syndrome as including all possible complications in relation to the feet of a diabetic patient. Diabetic foot syndrome is defined as the ulceration of the foot, from the ankle downwards. Causes of foot ulceration include peripheral sensory neuropathy, vascular disease (ischaemia) and infection
common acute injury seen in the elderly. Skin tears are wounds that often pose significant challenges
From observation, currently, the risk of delayed wound healing is managed, by nursing interventions and verbal health promotion, which may be due to the deficiency of packages designed for patients. This is supported by Collier (2003), who highlights the importance of nursing assessment, interventions and evaluation in improving wound healing. However, the importance of patients’ education, about balanced nutrition and dietary control of diabetes, may not be under estimated, as this may reduce the risk of infection and improve wounds healing (Casey, 1998, Dealey, 2005, Kemp, 2001, Timmons 2003, Ward, 2002). According to patients’ experience, their knowledge about nutrition helped them to achieve wound healing (Wound Care Information Network, 2008). For example, balanced proteins intake may encourage tissue repairs, as well as vitamin C intake may reduce the risk of infection, which may improve wound healing (Kemp, 2001, Ward,
Sherman Red is an 80-year-old male who was diagnosed with diabetes six months ago and is now admitted to the local hospital for a diabetic ulcer to his right great toe. The toe is infected and the patient is diagnosed with possible sepsis. The scenario depicts a presentation of sepsis in the elderly. This shows how wound healing and care of a diabetic patient can be difficult if not followed closely. The complication that can result from a diabetic ulcer can be devastating. It is always important that a patient is in full compliance with the treatment to prevent other health problems. The infection of the wound could have been avoided if treatment was taken seriously. The nurse must conduct a head to toe assessment of the
The recommendations for change to practice at the level of the provider would include first treating the underlying problem that Mrs. Smith was admitted for. According to the literature, a progressively worsening diabetic foot ulcer involves implementing a multitude of strategies to prevent amputation of the limb. This allow for decreased rates in mortality and can increase quality of life. Adequate wound management such as debridement, and offloading techniques should be instilled. Furthermore, education by the provider would be of critical importance for Mrs. Smith in terms of consistent foot care and management of her disease process (Yazdanpanah, Nasiri, & Adarvishi, 2015). Due
Diabetic Peripheral Neuropathy (DPN) is one of the most common microvascular complications in diabetes and can result in foot ulceration, ampuation and an impaired quality of life(Carrington AL, et al 2002,Boulton AJ,et al 2004). The reported prevalence of diabetic peripheral neuropathy ranges from 16% to as high as 66%2 and its prevelance is believed to increase with the duration of diabetes and poor glucose control.(Boulton AJ.et al 2000) It’s accounts for 50–75% of non-traumatic amputations in diabetic patients.(Holzer SE, et al 1998, Boulton AJM, 1998,Malay DS, et al 2006)
The recommendations for change to practice at the level of the provider would include first treating the underlying problem that Mrs. Smith was admitted for. According to the literature, a progressively worsening diabetic foot ulcer requires implementing a multitude of strategies to prevent amputation of the limb. Adequate wound management, including debridement if required, and offloading techniques should be instilled for Mrs. Smith. Furthermore, education by the provider would be of critical importance for Mrs.
According to Healthy People 2012 there are more then 800,000 new cases of diabetes each year, with the numbers on the rise. With this in mind, Healthy People 2012 has identified diabetes as their number five focus area. In order to reach their goal of improving the quality of life for people with diabetes they have identified diabetes teaching as their number one objective. Furthermore, in order to reduce the number of complications of diabetes, Healthy People 2012 has identified foot ulcers as their ninth objective. Through patient education Healthy People 2012 hopes to reduce the number of foot ulcers in people with diabetes, as diabetes is the number one cause of nontraumatic amputations in the United States. In order to
The diabetic foot disease is the leading cause of non-traumatic lower-limb amputation and results from three common pathologies: diabetic peripheral neuropathy, peripheral arterial disease, and infection. Late complications include foot ulceration, Charcot neuroarthropathy and amputation (Turns, 2013, p.422) though another specialist like, Iraj who wrote Prevention of Diabetic Foot Ulcer, added to the most common facts: deformities and minor