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Diabetic foot ulcers:The Wound Care Information Network:"Treatment: First, you must determine the cause of this ulcer. Is it neuropathic, ischemic or a combination? Base your treatment protocol on the etiology of the ulcer. Assuming that there is adequate perfusion to heal a plantar ulcer, one should have appropriate shoe modifications made to disperse weight away from the ulcerative area. Absorb any excess discharge and maintain a moist wound environment with appropriate product selection. Keep the wound edges dry. Make sure no sinus tracking occurs. Watch for infection. Debride necrotic debris and the hyperkeratotic rim as they are niduses of for infection." http://www.medicaledu.com/diabetic.htm See also:Staging Pressure Ulcers Application for All wound types:woundcare.co.za:"Treatment for Diabetic Patients, must be carried out as soon as possible, as any delay in time will cause the wound to take longer to heal. Day 1 This patient refused amputation of his leg. Had been five times to theater for skin grafts. Had been in hospital for 6 months....Debridement of some wounds like leg ulcers might be painful, due to poor blood circulation and severe damage to limited tissue areas. Secure leg ulcers with a pressure bandage to promote blood circulation. Exudate escaping the wound might cause a burning sensation due to inflammation. Painkillers are recommended." http://www.woundcare.co.za/id37.htm Wound care for diabetic ulcers:footDrHorsley.com:"Debridement of the wound is the first steps in treating this condition. Thick layers of skin (corns and calluses), which should be carefully removed until a satisfactory border is present, may cover ulcers. Your podiatrist may require that you wear special footwear, have a culture done, or get x-rays. Additional treatments for ulcers other than local wound care include hyperbaric oxygen (HBO), growth factors, and electrical stimulation. Even after successful treatment, there is a very high probability of reoccurrence. Continue to thoroughly inspect your feet and see your podiatrist on a regular basis." http://www.footdrhorsley.com/health/diabetic_ulcers.html Care of diabetic food ulcer:askDPM.com:"Your podiatric physician will then debride the ulcer to remove the surrounding calluses and any non-viable tissues. A wound dressing is then applied with either wet-to-dry wound dressing or a particular wound gel (see Wound Care Product). An x-ray of your feet may be required if your physician is suspecting possible underlying bone infection (osteomyelitis), or excessive pressure causing by bony prominence." http://www.askdpm.com/Diabetic%20Ulcers.htm Regranex Gel plus good wound care helps heal diabetic ulcers faster:Doc's guide:"Clinical trials demonstrated that a once daily topical application of Regranex Gel plus good wound care healed more diabetic neuropathic ulcers than a placebo gel plus good wound care. Regranex Gel was well tolerated in all clinical trials. Incidence of adverse events was similar in patients treated with Regranex Gel, placebo gel or good wound care alone. The product has not been studied in the treatment of diabetic neuropathic ulcers that do not extend into the subcutaneous tissue or beyond (Stage I or Stage II, IAET staging classification). The efficacy of Regranex Gel for the treatment of non-diabetic ulcers is under evaluation." http://www.docguide.com/dg.nsf/PrintPrint/E2EDCC1C8EB5DE4F852565E8004AF8AB Diabetic foot ulcers:wounds1.com:"Treating a diabetic foot ulcer involves debridement of the unhealthy tissue in the wound bed and removal of the callous around the edges of the ulcer. Your doctor may debride the wound several times to keep it clean and allow new cells to fill in the ulcer. If your doctor suspects an infection, he may order bllod tests and X-rays, and may recommend antibiotics. Your doctor will choose dressings prevent the wound bed from drying out or that absorb drainage from the ulcer, depending on the patient's individual needs. Dressing a wound helps protect it and acts as a barrier to prevent contamination. Advances in tissue engineering, growth factorsand antimicrobials have paved the way for more advanced treatments. Your doctor may consider using advanced products when foot ulcers have a difficult time healing." http://www.wounds1.com/care/condition20.cfm/3 Moist Wound Dressings:body1.com:"Moist wound dressings are the new frontier in wound care management. A seismic shift in wound care management favors moist healing for treatment of chronic wounds. A moist wound bed promotes the body’s natural process of healing and tissue growth. Moist wound healing maintains an isolated moist wound environment through the application of moisture-retentive, occlusive, and semi-occlusive dressings." http://www.body1.com/care/index.cfm/8/67 Get to the "Foot" of it:diabeticfootcare:"Proper diabetic Foot care should be a part of the diabetic persons daily routine. Lack of feeling in the feet necessitate even closer daily observation. Obesity may prevent the person from being physically able to view their feet. A family member, neighbor, or a visiting nurse may need to perform this important monitoring for developing diabetic foot problems" http://diabeticfootcare.tripod.com/ Total Contact Casting for Diabetic Neuropathic Ulcers:ptjournal.org:"Total contact casts are indicated for superficial plantar ulcers (ie, Wagner grades I and II) in the presence of decreased or absent sensation.[3] Wagner grade I and II ulcers are defined as ulcers that involve the epidermis, dermis, or other subcutaneous layers (deep fasciae, muscles, tendons, joints, or bones) but that are without evidence of infection.[4] Total contact casting is contraindicated in deep foot ulcers where abscess, osteomyelitis, or similar deep infection or gangrene is present (Wagner grade III, IV, or V).[3] These cases typically require immediate surgical attention or amputation" http://www.ptjournal.org/pt_journal/abstracts/sinacor.cfm A single-stage surgical approach provides comprehensive treatment of diabetic foot ulcers:wounds.com:"97 percent of the wounds healed. The median time to heal was 31 days. The recurrence rate was 10 percent over 6 years. In contrast, patients who undergo standard wound care have an ulceration recurrence rate of 50 percent over two years. The single-stage approach eliminated the need for additional surgical procedures and provided the patients an expedient return to footwear and bipedal function" http://www.wounds.com/article1.html Procedure for diabetic foot ulcer-full thickness:SkinWound.com online training manual:"Suggested Products Hydrogel impregnated gauze or tube Rope alginate if heavily draining Barrier ointment Wound cleanser. Desired Patient Outcome Ulcer will heal. Patient will frequently inspect feet for pressure areas or callous formation and report. Appointment with podiatrist for debridement if necessary." http://www.skinwound.com/online_training_manual/diabetic_foot_fullthickness.htm Taking diabetic foot wound care into the new millennium:Wound Care:"Nonhealing foot ulcers are the major cause of morbidity in diabetic patients. This can include infection, immobility, and lower extremity amputation. Relatively simple and comparatively inexpensive interventions may decrease the amputation rate up to 85%.1 It is important for caregiversof diabetic patients to be aware of the extent of the problem as well as the availability of solutions to aid their patients" http://www.mmhc.com/hhcc/articles/HHCC9903/Millington_hhcc.html Search Nursing Diabetics http://www.nursingdiabetics.com/A-Z_list/ ******************************************************
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Ulcer (diabetic ulcer):
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