Neuropathy

WoundSource Editors's picture
Diabetes and wound healing

By the WoundSource Editors

For individuals with diabetes, all wounds are a serious health concern and require careful attention. Because of diabetic peripheral neuropathy, skin cuts and blisters often go unnoticed until they become more complicated to heal. In addition, internal wounds such as ingrown toenails, skin ulcers, or calluses can cause breakdown of tissue and an increased risk of infection. Even small cuts and insect bites can cause wound healing difficulties in patients with diabetes. Here are common factors of diabetes that impact wound healing:

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diabetic foot ulcer treatment

By the WoundSource Editors

Estimates are that by 2030 there will be 550 million individuals with diabetes in the world. Because almost a quarter of all people with diabetes will develop a foot ulcer at some point, health care workers need to know the best practices for diabetic foot ulcer prevention and treatment.

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Aletha Tippett MD's picture
study on statins

By Aletha Tippett MD

Oh, what a shock to see a study published on atorvastatin treatment in the adult patients at risk of diabetic foot infection in a recent issue of Wounds.1 The conclusion of this study was that taking atorvastatin for at least three months reduced the risk of diabetic foot infections (DFI). The authors also theorized that statins could prevent infection in patients with diabetes.

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By Diana L. Gallagher MS, RN, CWOCN, CFCN

I recently had the honor of participating in a meeting of the Wound Ostomy Continence Nursing Certification Boar> (WOCNCB®). My role was to assist the Foot Care Committee with the evolution of the exam for certification in foot care nursing. All WOCNCB exams are expanding to a larger format based on the recommendations of the testing industry. The committee worked diligently to assure that item inclusion matched the test blueprint which in turn matched the job analysis that had been completed earlier this year. There is SO MUCH work that goes on behind the scenes to maintain examinations that are worthy of the WOCNCB's "Gold Standard." Participating in this meeting was truly an honor. As one of the members of the original committee for foot care nursing, I could not have been prouder of the progress that has been made in the past decade.

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WoundSource Editors's picture

By the WoundSource Editors

The term diabetic foot refers generally to the increased occurrence of complications in the feet of patients with diabetes mellitus. The most common foot problems related to diabetes are peripheral neuropathy leading to ulceration, vascular disease, increased risk of infection, and deformities like Charcot arthropathy. Complications arising from diabetes are the most common non-traumatic injury to cause lower extremity amputation.

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Aletha Tippett MD's picture

By Aletha Tippett MD

Many have never heard of diabetic foot complications Charcot foot, or at least don't know what it is. If you care for individuals with diabetes who have neuropathy, you almost certainly will see Charcot foot. My patients with Charcot have told me they have a disease of the foot "with crumbling bones." This is actually fairly accurate. Charcot is a neuropathic bone disease that causes osteoporosis-type destruction of the bones in the foot. As a result of this, the bones shift and move and break.

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By Margaret Heale, RN, MSc, CWOCN

I have been living with my daughter for almost a year and helping out at a nursing home where my granddaughter works. I don't remember having this problem last year but my skin is just on fire at times, itchy, itchy, itchy! I found a cream but ran out and couldn't remember what it was called. When I got to the pharmacy and told the lady there that I was in search of a product whose name I thought sounded like 'Narnia' she pointed me in the right direction. Then, to my surprise, she added, "but remember not to go through the wardrobe door or you might get more than you bargained for." We laughed so much I remembered I best go to the feminine hygiene section. I just wanted a slim little pad, you know for the odd cough or sneeze, but—ohhh—what a choice!

Aletha Tippett MD's picture
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By Aletha Tippett MD

In 1771, Luigi Galvani discovered that the muscles of a frog leg contracted when touched by a spark. This spawned the beginning of our understanding of the relationship between electricity and electrical stimulation and its effect and use on the human body. One thing that is often overlooked when caring for wounds is the impact that electricity can have on wound healing. It is used in the form of electrical stimulation, most often applied by a physical therapist. In her wonderful book, Wound Care: A Collaborative Practice Manual for Health Professionals, Dr. Carrie Sussman provides the rationale and procedures for using electrical stimulation to promote wound healing.

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Lydia Meyers's picture

By Lydia A Meyers RN, MSN, CWCN

Diabetes is the number one cause of amputation for wound care patients. Individuals with diabetes need monitoring and education about the dangers they face on a daily basis due to their condition. Diabetic ulcers often begin with a simple bump, as a callous or by stepping on something.

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Aletha Tippett MD's picture

By Aletha Tippett MD

The great medical pioneer, Dr. Paul Brand, was right when he said it's not about medicine, it's about mechanics. Think of the ulcers you are asked to see and treat. I hope the first question you ask about any wound is "how did this get here?" If the mechanics of a wound are not addressed, the medicine will not be successful.