Risk Factors

By Mary Ellen Posthauer RDN, CD, LD, FAND

We have all heard the terms Marasmus and Kwashiorkor used to classify malnutrition that stems from the classic 1974 The Skeleton in the Closet article. Current research on this topic led to the collaboration and 2012 publication of a consensus statement of the Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.): Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition).

By Mary Ellen Posthauer, RDN, CD, LD, FAND

After reading Laurie Swezey's blog, "Diabetic Foot - Risk Factors and Prevention", I decided to weigh in on the issue of poor glycemic control. Teamwork is an essential ingredient since achieving glycemic control is a challenge for all clinicians including the registered dietitian (RD).

By Paula Erwin-Toth MSN, RN, CWOCN, CNS

Winter weather is upon us and that brings a whole host of challenges. Our skin is more liable to experience dryness, cracking and breakdown. Everyone, especially older adults, are more vulnerable to falls due to slippery steps and walkways. Shoveling heavy, wet snow has been associated with increased risk of heart attacks. Just heading to the mailbox, grocery store or the doctor's office can spell disaster. All of these situations can combine for a 'perfect storm' for risk of skin breakdown at home and all healthcare settings.

By Aletha Tippett MD

Tetanus is a multisystem disease caused by the bacterium Clostridium tetani. This bacterium is present in feces and soil. Tetanus has been mostly eradicated in the U.S. due to childhood immunization, however, there have been reported cases among immigrants, with higher risk behaviors such as body piercing and tattooing among young adults, and with failure to maintain adult booster immunization. Often, as adults, tetanus is not considered in overall health as evidenced by significant under-immunization with less than half of adults having current immunization. Other risk factors not well-recognized include diabetes, gangrene or chronic wounds, which increase the risk of tetanus to 50%. It is fatal in approximately 10-30% of cases. It may take anywhere from 3-21 days after exposure to the bacterium for the symptoms to become apparent. There is no test to diagnose tetanus, it is strictly a clinical diagnosis.

by Paula Erwin-Toth MSN, RN, CWOCN, CNS

Part 3 in a series discussing the challenges and opportunities in patient/family education
For Part 1, Click Here
For Part 2, Click Here

by James McGuire, DPM, PT, LPed, FAPWHc

It is essential that the various offloading devices available to the wound care professional are applied appropriately to redistribute destructive forces that develop in the diabetic or neuropathic foot during standing and ambulation.^1,2 The 6 "W" approach was first introduced in an article in 2006³ to help practitioners better understand the biomechanical risk profile of patients at risk for ulceration so that they could better choose between the various offloading interventions available for their everyday footwear.

By Mary Ellen Posthauer RDN, CD, LD, FAND

Since undernutrition is considered a reversible risk factor for pressure ulcer development, then early detection and management of undernutrition is essential.

By Aletha Tippett, MD

This is a statement the cardiologist made to my patient the other day. My patient is a diabetic man with severe neuropathy, resulting in pain and numbness in his feet, as well as difficulty walking. He also has a serious cardiac history with multiple myocardial infarctions. When he first came to me he was, of course, on a statin medication for his heart. One of my tenets for treating neuropathy is to stop statin treatment because it can increase neuropathy 26 fold (1).

By Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 7

I know we all look forward to the New Year as one of promise, self-evaluation, and a new vision for brotherhood among men. In that spirit, as this is the first of my “ramblings” for 2012, I want to take the time to offer my heartfelt wishes for each of you that read my blog to have a horrifically catastrophic and agonizing condition, something equivalent to what is felt when discovering the first scratch on your new car.

By Mary Ellen Posthauer RDN, CD, LD, FAND

In addition to providing calories and protein to promote wound healing, fluid intake is equally important. Achieving hydration needs and preventing dehydration, a risk factor for pressure ulcer development due to its effect on blood volume and skin turgor, is vital.