6 Key Steps to Preventing Diabetic Foot Ulcers and Amputations
February 20, 2014
By Dr. Mark Hinkes, DPM
Twenty first century technology is helping people with diabetes to heal foot ulcers. An Australian colleague, for example, is developing an application that reminds people with diabetes to control their blood sugars with prompts and instructions, and allows them to upload a picture of their wound for their podiatrist to evaluate.
6 Ways to Improve Patient Care with Personalized Medicine
February 23, 2017
Margaret Heale, RN, MSc, CWOCN
"Personalized medicine" is apparently a new concept that has evolved from taking good family histories, then adding a genetic testing component. The idea is to help assess the risk of specific traits that may be evident, and confirm with genetic testing so people can make lifestyle changes that reduce risk. It has attracted a huge amount of attention over the past few years.
A Case Study on the Combined Use of an Epidermal Autograft and NPWT
January 21, 2016
By Samantha Kuplicki, MSN, APRN-CNS, AGCNS-BC, CWS, CWCN, CFCN
This is the account of a patient case in which technology, clinician experience, and patient adherence converged to save a limb.
Amputation Prevention: Representation Matters
April 22, 2022
Benjamin Franklin famously stated, “An ounce of prevention is worth a pound of cure.” This statement was made in reference to the importance of fire prevention in 18th century Philadelphia, but it aptly applies to modern diabetic limb salvage. The multidisciplinary model for amputation prevention has been in place now for almost two decades, but how far have we really come? Recent literature suggests that there has not been a significant decline in reamputation rates for diabetic patients despite the team approach to care. Diabetes is a complex and aggressive disease that affects multiple organ systems and robs patients of sight, sensation, limb, and quality of life. Treating such an aggressive disease is challenging, to say the least, and often the desired outcome is not achieved.
Ankle-Brachial Index and Transcutaneous Oxygen Measurement Before Compression Therapy
February 26, 2014
By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS
Patients who come in with venous insufficiency ulcers and lower extremity arterial disease (LEAD) should be evaluated for compromised vascular status and the use of compression. The purpose of the ankle-brachial index (ABI) test is to support the diagnosis of vascular disease by providing an objective indicator of arterial perfusion to a lower extremity.
Can Amputation be Palliative?
August 7, 2013
By Aletha Tippett MD
In considering this question as to whether amputation can be palliative, let’s keep clear that these are two separate subjects that sometimes interact. It is key to always keep our goals in mind. What is the goal in palliative care? The goals are to provide comfort, relieve pain, prevent infection, and improve or maintain quality of life. These goals are always to be in concert with the desires and wishes of the individual patient.
Combat Wound Management: An Overview
July 11, 2018
As a veteran of the U.S. Army, and having a grandfather who was a U.S. Army combat medic, I have always had an interest in combat wound care. Wound care has evolved immensely throughout the years in the military arena. The treatments used as far back as the fifth century B.C. were inconceivable. Examples are keeping wounds dry, wound irrigation with water and wine, burning oil into infected wounds, and topicals such as egg yolks, rose oil, and turpentine applied to the wound bed. Odor was controlled with bags of lavender at the soldier’s bedside.
Comprehensive Amputee Care: Not Such a New Concept
January 27, 2023
A limb salvage program aims to prevent major amputations and thus improve patients' quality of life and overall longevity. Despite the efforts of a multidisciplinary team approach, amputation prevention remains a challenging endeavor.1 Providing both physical and socioemotional guidance for patients undergoing a major amputation is crucial for recovery. A multifaceted approach to post-amputation care may seem like a relatively modern concept, but it has deep roots in earlier civilizations.
Diabetic Foot - Risk Factors and Prevention
April 19, 2013
By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS
Diabetic foot ulceration can lead to significant morbidity and mortality and is probably one of the most-feared complications of diabetes. Loss of limb (amputation) is a frequent outcome of diabetic foot ulceration.
How to Implement Diabetic Foot Ulcer Prevention
May 20, 2022
Diabetic foot ulcers (DFUs) are open sores or wounds caused by a combination of factors that include neuropathy (lack of sensation), poor circulation, foot deformities, friction or pressure, trauma, and duration of diabetes with complication risks. DFUs occur in 34% of people with diabetes, and approximately 14% to 24 % of patients with diabetes who develop a DFU will require an amputation.