Wound Healing

Diabetes mellitus type II is considered as an adult-onset form of diabetes. It is characterized by high glucose levels in the blood. The body of a patient develops insulin resistance and relative insulin deficiency. From Improving Diabetic Wound Care Outcomes: A Practical Guide it is evident that individuals ailing from type II diabetes usually have higher resistance in healing their wounds. This is one of the largest problems healthcare faces, given that the number of individuals with diabetes is increasing; it is actually facilitated by changes in the lifestyles of people. Some questions posed on the treatment of wounds on patients ailing with diabetes are based on the need to provide adequate treatment of wounds given the high resistance to healing of such wounds (Hanft et al., 2012).

Physical assessment conducted on the Patient BW is in line with the requirements provided in the article. Essentially the Patient BW showed the presence of a stable vital sign. Results conducted in line with the necessary medical procedures in the treatment of Diabetes and related complications indicate that the Patient BW had a BP-138/79 mmhg, a respiration of 18, and a heart rate of 78. In addition, blood sugar tests, which are a necessity to provide clarifications in terms of the probability of a wound healing, indicate that the Blood sugar level monitor via finger stick stood at 327 mg/dl. In addition, the nurse prepared and administered novolog 9 units subq given on left deltoid using rotating sites per aseptic techniques and universal precautions. Furthermore, the patient was also assisted to void and ambulate by the respective caregivers.

Patient BW has been diagnosed with Perianal abcess coupled by the presence of right foot toe ulcer. He has the possibility of developing resistance to healing of the wound. For instance, the article provides an example of wounds with a higher level of resistance to healing in individuals ailing with type two diabetes mellitus. Foot ulcers are considered among the most complex forms of wounds especially for individuals with diabetes. More conclusive studies and tests on the healing of the disease are required especially in patients ailing with diabetes. This is essential, as it would provide relevant and sufficient information about the necessary conditions for healing wounds such as foot ulcers and the effects of diabetes in the healing process of wounds. Such information is relevant since it would provide healthcare givers with new approaches and perspectives about wound healing especially in patients ailing with diabetes (Hanft et al., 2012).

Other wounds as evidenced by the Patient BW diagnosis such as perianal abscess are wounds, which could be easily characterized as unable to heal. Wounds such as foot ulcers and perianal wounds as evidenced by the patient BW require advanced forms of care, as they are susceptible to infections (Hanft et al., 2012). The wounds need to be cleaned regularly with normal saline and dressed with Kerlix every 24 hours until they heal to completion. The necessity of cleaning the wound each 24 ours is due to the need to observe the healing process as well as prevent and curb the presence of infections (Hanft et al., 2012).

Patient BW is a diabetic who is susceptible to contraction of infections especially due to his wounds, which could develop resistance. From the article, it is evident that more than 35% of the individuals ailing with diabetes usually require dialysis, whereas another 29% of the ailing individuals eventually lose their sight. Diabetics usually have higher mortality rates in comparison to other non-diabetic individuals. Diabetics also suffer from possible amputations due to spread of the foot ulcers (Hanft et al., 2012). 25% of individuals ailing with diabetes resulting in foot ulcers as well as other wound infections are usually hospitalized. 4.3% of all diabetics usually undergo amputations to eliminate the spread of the foot ulcers. Other 20% of the sufferers usually die from complications associated with the disease (Hanft et al., 2012). The article also indicates that individuals with foot ulcers as well as other chronic wounds associated with diabetes usually have a higher mortality rate of 13.8% in comparison to individuals with diabetes (Hanft et al., 2012).

The article essentially provides the rates and figures in terms of susceptibility to death and spread of an infection. This is essential in indicating the rate of spread of the disease and its implications to patients, as well as the healthcare givers. As the article indicates, there is a necessity to develop a multifaceted approach in addressing the disease and its implications such as foot ulcers and perianal wounds. Hence, it is evident of the dire need to provide the patients ailing with diabetes with appropriate care to save them from possible amputations and other complications associated with diabetes. Such an agreement in terms of the need to look for better approaches to curb the spread as well as addressing the disease and associated symptoms (Hanft et al., 2012).

The wounds developed by the Patient BW show no signs of infection. However there is need to conduct adequate clinical testing to establish the possibility and susceptibility of infections. The question of addressing the issue of wounds is relevant in that it enables tabling of various proposals in terms of the various approaches, which could be used in providing the appropriate health care to the patients ailing with diabetes coupled by wounds such as perianal wounds and foot ulcers. It is agreeable that there is a need to evaluate the various aspects, which could affect and inhibit wound healing. They include the need to evaluate the presence of what is described as co-morbidities, which affect the wound healing processes. Co-morbidities affect the end stage renal diseases, cardiovascular, peripheral vascular and pulmonary infections that are among the main complications developed by individuals ailing with diabetes at an advanced stage. Such infections if not addressed appropriately have the potency to develop into fatalities (Hanft et al., 2012).

The article also provides that there is a dire need for risk assessment in establishing the appropriate means of treatment of the wound. A growth in size as pointed out in the article is an express indication of the presence of underlying infections (Hanft et al., 2012). Other assessments could include the evaluation of the depth of the wound as well as bone biopsy to establish the possible presence of osteomyelitis. Hence, any form of suspicious changes in terms of the wound behavior should be evaluated through medical testing to ascertain the presence of infections as well as evaluation of the healing process of infection. It also cautions the possibility of infections even if medical tests indicate otherwise. This should be informed by the increase in the size of the wound, which might differ from typical clinical procedures for establishing and presenting infections (Hanft et al., 2012).

Patient BW showed signs of alertness, awake and oriented x 3, PERRLA, bowel sound active x 4 q, lung clear bilateral, normal heart sound s1 and s2 present and good tugor. The Patient BW’s wounds could be induced to heal by the use of anti-microbial agents in addition to cleaning and dressing with the saline solutions and kerlix respectively. The article also provides for the need to use anti-microbial agents for reduction of the bio-burden on the wounds. Such are easily available to healthcare givers given the presence of diverse anti-bacterial agents. However, evidently, there are contradicting statements on the use of silver-based antibacterial agents. This emanates from the notion that silver based products and dressings could play a significant role in the reduction and prohibition of infections on wounds. Hence systemic agents are the only reliable agents which could be used in the reduction and curbing of infections in the wound (Hanft et al., 2012).

Nutrition plays a significant role in inducing speed in the healing process of the wound. Elements such as hemoglobin reduce foot ulcer by an approximate 14.3%, which is quite considerable (Hanft et al., 2012). This is an express indication of the need for observance of a healthy diet for patients to ensure healing of the wounds. Both consumption of alcohol and uptake of tobacco are a healing process of wounds for patients with diabetes. The article indicates the presence of non-responsive wounds. Such could be treated by inducing healing using modern technology and therapies. Given the low level of hemoglobin, the Patient BW could be directed to increase uptake of foods with high levels of iron and hemoglobin to induce the healing process.

The process of providing treatment of wounds as stated in the article is delicate. This view is enhanced by the possibility of the patient complications. Hence, there is a need to understand the various processes, which could be assumed in unique scenarios for ailing patients with diabetes. In essence, change in the wound should be evaluated to establish the rate of healing, resistance to healing or the presence of infections and the eventual establishment of an appropriate means of treatment of wounds. No signs and symptoms of infection noted, however Patient BW reported pain on perineal are 7/10.

In conclusion, the Patient BW should be given a higher diet of foods rich in hemoglobin to increase the rate of healing. Additional tests could also be carried out to ensure that there is absence of infections that would lead to disease. In line with the article, the treatment process is of high quality because of the regular monitoring of the disease to ensure absence of infections. The treatment and care of the patient could be termed as relatively good. However, there is need for improvement in terms of conduct of clinical tests and ensuring a higher diet for eventual healing of the stated wounds.

References

Hanft, J., Surprenant, M., & Buttita, O. (2012). “Improving Diabetic Wound Care Outcomes: A Practical Guide” Podiatry Management, 31(5), 117-120.