Implementing the Triangle of Wound Assessment framework to transform the care pathway for diabetic foot ulcers

2020 ◽  
Vol 29 (6) ◽  
pp. 363-369
Author(s):  
Silvia Blasco Gil

Treating patients with hard-to-heal wounds can be a daily challenge for health professionals. A systematic approach is needed to establish accurate management goals and treatment options. This should include a complete wound assessment that takes into account the wound aetiology and characteristics, as well as the patient as a whole. The Triangle of Wound Assessment is a holistic framework designed to assess and manage all wound areas—the wound bed, wound edge and periwound skin. The framework can be used to guide health professionals when evaluating a wound, setting management goals and selecting treatment options. This article describes the use of the Triangle in clinical practice. It shows how a Spanish hospital implemented the framework and how this led to its inclusion in the diabetic foot ulcer (DFU) care pathway used in the region. The article concludes with three case studies describing the clinical outcomes achieved following implementation of the Triangle when managing wounds.

Author(s):  
Gusti Jhoni Putra ◽  
Cau Kim Jiu ◽  
Kharisma Pratama ◽  
Syahid Amrullah

Objective: One of the purpose in diabetic nursing care is to Improve the quality of life of patients with diabetic foot ulcer (DFU). Some aspects must be considered in patients with DFU, the aspects include in Social Aspects, that are Support of Family, Environtment, Self Esteem and Economy. This is because of the support, activity and relationship influence on physiological and quality of life. Unavailability of sosial assessment to DFU can affect in determining the appropriate diagnosis and intervention. The purpose of this research is to develop the social support in wound assessment instrument for patients with DFU. Method: This research method was mixed method with sequential exploratory approach. There were 9 participants for qualitative methods and 103 respondents for quantitative methods. Validity test were by Pearson product moment with test retest approach, reliability test was by Cronbach alpha. Aiken’s V was used to Content validity index test for 2 experts. Result: Nine themes emerged from the qualitative methods for social support. 35 items measuring instrument obtained a valid (0,372-0,843 > 0,235) and reliable results (Cronbach alpha 0,959 and 0,976). Result of content validity index is valid by 0,67-0,83. Conclusion: This study found 9 themes for social support, and the development of family support in wound assessment for diabetic foot ulcer patient that consist of 35 items is valid and reliable.


2018 ◽  
Author(s):  
Paul J Kim

The clinical manifestations of diabetes are evident in the foot. Peripheral neuropathy, peripheral vascular disease, dermatologic alterations, and musculoskeletal changes place the foot at high risk of ulceration. The diabetic foot ulcer (DFU) is the end result of these pathophysiologic changes, which increases the likelihood of infection, hospitalization, and amputation. There are treatment options available, but DFU imparts a tremendous toll on the patient’s quality of life and healthcare resources. Although there is a growing understanding of the pathophysiologic processes unique to the diabetic foot, much work is still needed. This chapter focuses on the assessment and management of the diabetic foot and its associated conditions.  This review contains 7 figures, 3 tables and 62 references Key Words:: Diabetic foot, Diabetic Foot Ulcer, Peripheral Neuropathy, Peripheral Vascular Disease, Foot Wound, Biomechanics, Deformity, Biomechanical Surgery, Infection


Medicina ◽  
2020 ◽  
Vol 56 (8) ◽  
pp. 380
Author(s):  
Bogdan Uivaraseanu ◽  
Simona Bungau ◽  
Delia Mirela Tit ◽  
Ovidiu Fratila ◽  
Marius Rus ◽  
...  

Background and objectives: Diabetic foot ulcer (DFU) is one of the serious complications of diabetes, being related to frequent and long-term hospitalisation, reduced quality of life of the patient, amputations, a high rate of morbidity and mortality. The bacterial aetiology is complex, sometimes involving more than one pathogen, playing a major role in the infection prognosis and development of microbial resistance. This study evaluated the current state of the aetiology, clinical and pathological characteristics of DFU in a single diabetes centre in order to provide some specific measures to prevent it. Materials and Methods: This retrospective study was conducted on patients with diabetes mellitus (252 individuals diagnosed with DFU) between January 2018–December 2019. All participants were assessed based on their clinical characteristics, including complications of diabetes and pathological and microbiological evaluations. Results: The present research revealed that diabetic foot ulcer prevalence was higher in males than in females and higher in type 2 diabetic patients than in type 1 diabetic patients. The patients with diabetic foot ulcer were older, had a higher body mass index (BMI), longer diabetic duration and had more diabetic complications, such as retinopathy, diabetic polyneuropathy and diabetic kidney disease, than patients without diabetic foot ulceration. Conclusions: Taking into account all factors involved, including the aetiology and the antibiotic susceptibility pattern of these isolates, planning the suitable treatment options of patients is possible.


Author(s):  
Dr. Devi Das Verma ◽  
Dr. Anil Kumar Saxena

Introduction:  Diabetes is one of the most prevalent metabolic chronic diseases due to the imbalance production of insulin. One of the studies reported that in 2010 worldwide 285 million adults had diabetes and this figure may be increase to 439 million by the year 2030. Globally Diabetic foot ulcers (DFUs) constitute major health problem in people that significantly contribute to morbidity and mortality in diabetes patients. Approximate 1.0% to 4.1% of the annual population-based incidences of a diabetic foot ulcer (DFU) were reported. Due to this the lifetime may be as high as 25%. In Asian countries diabetic foot ulcer are major problems which are different from European countries or developing countries.  From many studies reported diabetic foot problems in India are infectious and neuropathic in nature as compared to developed countries. According to World Health Organization (WHO) diabetic foot is defined as lower limb of a diabetic patient characterized by infection, potential risk of pathologic consequences ulceration or destruction of deep tissues associated with neurological abnormalities, various changes in peripheral neuropathy vasculopathy and superimposed infection that are mainly responsible foot ulceration. Ulcers are one kind of abscess which is difficult to treat because of poor wound healing that result from a combination of neuropathy, ischemia and hyperglycemia.  Aim: The main objective was to study the outcome of treatment modalities and it’s relating factors to complication in diabetic foot ulcer.  Material and method:  Total 60 diabetic foot ulcer patients with the age range from 20 to 70 years were included.  From all the patients’ detailed past and present history were recorded.  For all the patients, general, physical and local and systemic examinations were also done. Detail   laboratory examination like Fasting and Post Prandial Blood sugar levels, blood count, ECG, ESR, complete urine examination for the presence of ketone bodies and sugar, x-ray as well as culture and sensitivity of the discharge from ulcer were also done. Patients were treated with various treatment methods like conservative treatment, split skin grafting and amputation. Result: In this study male patients were more in proportion as compared to female. This study showed that maximum with the age group 14 -50 (43.3%) years old followed by 18.3% in 31-40 years old, 16.7% in 61-70 years old.  6.7% showed the least age group as 20 -30 years old.  Out of total 60 patients, 38.3% of the patients showed diabetic ulcer foot which was more whereas 15% showed diabetic gangrene foot which was least. 25% showed diabetic cellulites foot and 21.7% showed as diabetic abscess foot.  Conclusion: Globally as diabetes mellitus cases are increasing and it became rapidly the public health problem. This may be due to burden on economy, health system and on society to manage the diabetic foot problems. Diabetic foot management guidelines must be made into our practice protocols which may preventing limb loss, and decrease mortality and increase the quality of life of the patient. Hence for this it is only possible with the help of foot care education and health care workers.  Hence, foot infection is to put first and care for it like hands. Keywords: Diabetes, foot ulcers, infections, amputations.


2015 ◽  
Author(s):  
Fakhraddeen Muhammad ◽  
Lateefah Pedro ◽  
Hassan Suleiman ◽  
Enikuomehin Adenike ◽  
Rahila Mukhtar ◽  
...  

2019 ◽  
Author(s):  
Maksym Prystupiuk ◽  
Iuliia Onofriichuk ◽  
Lev Prystupiuk ◽  
Ludmila Naumova ◽  
Marianna Naumova

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