skin integrity
Patient was instructed on measures to decrease fat in diet, such as foods should be baked, broiled, or boiled instead of fried. Trim visible fat from meats and remove skin from poultry. Substitute fish or chicken for beef, pork or lamb. Use skim milk instead of whole milk.
Patient was instructed on another leading type of chronic wounds is pressure ulcers. That occurs when pressure on the tissue is grater than the pressure in capillaries, and thus restricts blood flow into the area. Muscle tissues, which needs more oxygen and nutrients than skin does, show the worst effects from prolonged pressure. As in other chronic ulcers, reperfusion injury damage tissue.
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 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 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.
Instructed patient about some signs and symptoms of pressure ulcers, such as, skin tissue that feels firm or boggy, local redness, warmth, tenderness or swelling.
Patient was instructed on nerve damage as a complication of diabetes. Because of the lost sense of feeling in the extremities it is possible to not feel any discomfort in the feet, and it is also possible to develop sores that can turn into skin ulcers without being aware of it.
If your big toe slants sharply in toward your other toes, with a big bump on the knuckle of your big toe, you've got a classic bunion. Corns are spots of thick, rough skin, where the tissue builds up on toes constantly barraged by too much rubbing or pressure. A buckled-under toe, called a hammertoe, can result from muscle weakness caused by diabetic nerve damage. All of these make it hard to fit shoes comfortably. But a good podiatrist can help you fix these problems and take better care of your feet.