Foot-Care for Patients with Diabetic Foot Ulcers
THE ROLE OF DEBRIDEMENT IN WOUND HEALING OF PATIENTS WITH DIABETES FOOT ULCERS (REFLECTIVE ANALYSIS)
INCIDENT
As a registered nurse with over 10 years of clinical practice experience in various field of nursing including caring for patients with diabetic foot ulcers (DFUs), I was concerned with rise in the numbers of DFUs cases resulting into higher rates of amputation, disabilities and mortality . DFU are caused by a combination of peripheral neuropathy and vascular diseases resulting from diabetes mellitus (Army and Tanja, 2012). Statistics provided indicate that a limb is lost to improper management of DFUs every 30 seconds somewhere in the world (International Diabetes Federation, 2005). In addition, over 85% of lower extremity amputations in patients with diabetes occur in people with antecedent foot ulcer (Apelquist and Larson, 2000). Besides, DFUs have negative impact on quality of life of diabetic patients. In fact, diabetic patients with a history of DFUs had a 47% increase risk of mortality compared to those without a history of DFUs (Iversen et al, 2009). Delayed healing of DFU leads to reduced patients mobility, diminished quality of life and increased risk of lower extremity amputation (Army and Tanja, 2012). Approximately, 15% of individuals with diabetes have had an ulcer on the feet or ankle while five years recurrence ulcer in diabetic patients is about 70% (International Working Group on Diabetic Foot, 2003). Amputation is found to be higher cost to healthcare system because of multiple and prolonged hospitalization than the lower cost of wound management of DFUs (Krapfl and Gondes, 1999). The economic burden of DFUs and complications arising are enormous. The cost to treat a DFU over a period of 2 years was $27,987 in 1995 and based on medical component of U.S consumer price index rose to $46,841 in 2009 (Ramsey et al, 1999) and more than 50,000 amputations were performed on patients with DFUs yearly in United States (Chadwick et al,
INCIDENT
As a registered nurse with over 10 years of clinical practice experience in various field of nursing including caring for patients with diabetic foot ulcers (DFUs), I was concerned with rise in the numbers of DFUs cases resulting into higher rates of amputation, disabilities and mortality . DFU are caused by a combination of peripheral neuropathy and vascular diseases resulting from diabetes mellitus (Army and Tanja, 2012). Statistics provided indicate that a limb is lost to improper management of DFUs every 30 seconds somewhere in the world (International Diabetes Federation, 2005). In addition, over 85% of lower extremity amputations in patients with diabetes occur in people with antecedent foot ulcer (Apelquist and Larson, 2000). Besides, DFUs have negative impact on quality of life of diabetic patients. In fact, diabetic patients with a history of DFUs had a 47% increase risk of mortality compared to those without a history of DFUs (Iversen et al, 2009). Delayed healing of DFU leads to reduced patients mobility, diminished quality of life and increased risk of lower extremity amputation (Army and Tanja, 2012). Approximately, 15% of individuals with diabetes have had an ulcer on the feet or ankle while five years recurrence ulcer in diabetic patients is about 70% (International Working Group on Diabetic Foot, 2003). Amputation is found to be higher cost to healthcare system because of multiple and prolonged hospitalization than the lower cost of wound management of DFUs (Krapfl and Gondes, 1999). The economic burden of DFUs and complications arising are enormous. The cost to treat a DFU over a period of 2 years was $27,987 in 1995 and based on medical component of U.S consumer price index rose to $46,841 in 2009 (Ramsey et al, 1999) and more than 50,000 amputations were performed on patients with DFUs yearly in United States (Chadwick et al,
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