diabetic foot care
Diseases Process
Patient was instructed on what to avoid in presence of ulcers. Friction and shear need to be reduced. Friction is the mechanical force exerted when skin is dragged against a coarse surface while shear is the mechanical force caused by the interplay of gravity and friction.
Patient was instructed on the optimization of wound environment. Adequate nutrition and hydration, remove nonviable tissue, maintain moisture balance, protect the wound and peri-wound skin, eliminate or minimize pain, cleanse, prevent and manage infection, control odor.
Patient was instructed on adequate nutrition and hydration to minimize wound development. Encourage protein, calorie-dense foods and fluids (unless contraindicated), monitor intake, weight and skin turgor, assess and address impairments in dentition and swallowing.
Patient was instructed on eliminate or minimize pain of wound. Address the cause (remove the source if external, treat the infection or medicate based on physiological stimulus), pharmacological strategies
Patient was instructed on pain caused by pressure ulcers. Pain can be classified as acute or chronic. Cyclic acute pain, which is periodic and corresponds to the pain experienced during repeated management, such as dressing changes or patient repositioning and non-cyclic acute pain, which is accidental, including pain experienced during occasional procedures such as debridement or drain removal.
Patient was instructed on traumatic wounds. Contusions are caused by more extensive tissue trauma after severe blunt or blast trauma. The overlying skin may seem to be intact but later become non-viable. Extensive contusion may lead to infection.
Patient was instructed on wounds contributing facts. In addition to poor circulation, neuropathy, and difficulty moving, factors that contribute to chronic wounds include systemic illness, age and repeated trauma.
Patient was instructed on factors that may contribute to chronic wounds is old age. The skin of older people is more easily damaged, and older cells do not proliferate as fast and may not have an adequate response to stress in terms of gene up regulation of stress related proteins. In older cells, stress response genes are over expressed when the cell is not stressed, but when it is, the expression of these proteins is not regulated by as much as in younger cells.
Patient was instructed on factors that contribute in chronic wounds as repeated trauma. Repeated physical trauma plays a role in chronic wound formation by continually initiating the inflammatory cascade. The trauma occurs by accident, for example when a leg is repeatedly bumped against a wheelchair rest, or it may be due to intentional acts.
Patient was instructed on treating painful wounds. Persistent pain associated with non-healing wounds is caused by tissue or nerve damage and is influenced by dressing changes and chronic inflammation. Chronic wounds take long time to heal and patients can suffer from chronic wounds for many years.