HISTORY: Diabetic patient with ulcer on the bottom right foot. Images of the feet were obtained in a plane perpendicular to the long axis of the foot. Utilizing a T1-sequence an effective double-echo sequence and in a plane nearly paralleling the long axis of the foot utilizing an effective double-echo sequence. An additional sequence was performed in an attempt to do a fat saturation technique. However, motion artifact degrades the detail on these images limiting the use for evaluation. There is prominent abnormality evident in the right midfoot and forefoot. This consists of abnormally increased soft tissue present, predominantly plantar, medial to the tarsals and proximal to the metatarsals but also dorsal to the proximal metatarsals. At the distal aspect of this abnormality near the…
HISTORY: The patient is a 53-year-old black individual, who has had diabetes for at least six months, but thinks it has been longer than that. He has had a foot ulcer since January.…
HISTORY OF PRESENT ILLNESS: This is a 53-year-old black individual a patient of Dr. Shelton, who has had diabetes for at least six months, but he thinks it has been longer than that. He says his last known blood sugar was in the 300’s. He presents in the ER today with a foot ulcer since January of this year. He stated that it started with blisters where he had soaked his feet too long in hot water. He has had no eye examination for two years. There has been no surveillance of chronic complications of diabetes.…
Skin is the largest organ of the body, covering and protecting the entire surface of the body. The skin is primarily composed of three layers. The skin, which appears to be so thin, is still itself divided into epidermis, dermis, and subcutaneous layer or hypodermis. Each layer has it own function and own importance in maintaining the integrity of skin and thereby the whole body structure. Pressure sores or decubitus ulcers are the result of a constant deficiency of blood to the tissues over a bony area such as a heel which may have been in contact with a bed or a splint over an extended period of time. The surface of the skin can ulcerate which may become infected. Eventually subcutaneous and deeper tisssues are damaged. Besides the heel, other areas commonly involved are the skin over the buttocks, sacrum, ankles hips and other bony sites of the body.…
This would be under Endocrine, Nutritional, and Metabolic Diseases, and immunity Disorders – Codes 240-279, these codes classify a variety of conditions. The most common disease here is diabetes mellitus, which is a progressive disease of either type 1 or type 11. The nonhealing would on her left foot, cause be because she is a…
Postoperative Diagnosis: Diabetic plantar space abscess of the right foot, and grade 2 diabetic ulceration of the right foot.…
Diabetic Neuropathy, the areas where the nerves are damaged, are very common. It's caused by the high concentration of glucose. It can cause a patient to lose the control of an area in the body. The common areas are either the arm, feet or even both. Diabetics frequently feel numbness, tingling or even burning in their feet, and it can make the diabetic to injure themselves without them noticing. Cuts and blisters can turn to pressure sores, which become infected and very difficult to heal. These sores can cause the patient to lose a leg, foot, and even can cause the patient to…
Moffatt, C.J., Franks, P.J., Doherty, D.C, et al (2004), Prevelence of Leg ulcers in a London population…
Conditions that affect the flow of blood through the body, such as type 2 diabetes, can also make a person more vulnerable to pressure ulcers.…
Research by Woong Sohn et al.(2011) found that the risk of ulceration increased with BMI. A study that followed up diabetic patients for 5 years reported a 20% increased risk in foot ulceration for every 20kg increase in body weight. These results can be explained as pedal stress can be 3 to 5 times body weight, so those with high BMI’s place a lot of pressure of their feet as opposed to those with a lower BMI. When this is applied to the case of Mr Toe, who has caused trauma to his foot, the pressure on the plantar surface of his foot is significant enough to slow down the healing process and cause the ulcer to worsen without…
The first priority is damage to Bob’s pre-existing venous ulcer on his left lower leg. Falls can introduce infection and further impair skin integrity in existing leg ulcers, thus increasing the likelihood of secondary infections and associated complications (Doenges, Moorehouse, & Murr, 2014). The second priority is Bob's blood glucose levels. Bob is at risk for unstable blood glucose levels related to poor management of his type II diabetes. An analysis of blood glucose levels provides a method for monitoring the effectiveness of therapy and provides direction for alteration of medications, such as additional regular insulin, allowing treatment for underlying metabolic dysfunction, hyperglycaemia and promotion of wound healing (Doenges, Moorehouse, & Murr, 2014).…
In the United States pressure ulcers affect 3 million adults across the health care setting. Pressure ulcers have a major impact on quality of life, health status, and the cost of health care. The Centers for Medicare and Medicaid Services announced that they will not pay for additional costs due incurred for hospital-acquired pressure ulcers. They consider pressure ulcers acquired after admission to be preventable and will not reimburse hospitals for pressure ulcer treatment, these are considered secondary diagnoses and not their main reason for admission.1 Patients that are non-ambulatory due to physical or medical reasons are at a high risk for developing pressure ulcers with the highest incidence being in the ICU setting because…
There are instances where an acute condition can become a chronic condition an example of this would be a skin tear on the foot of a diabetic patient. Due to a patient’s co-morbidity of diabetes and the associated issues, healing time is lengthened, therefore it becomes a chronic condition that can involve treating a possible infection, and complex wound management, diabetic management, and review of nutrition…
Royal Wolverhampton NHS Trust. (2013) Leg Ulcer Management. Version 1. Wolverhampton: Royal Wolverhampton NHS Trust.…
o 62-year-old diabetic female presents for check-up and dressing change of wound on left foot. Examination reveals that the wound is healing. Nurse applied new dressing and patient will return for check-up in one week.…