Title: Choice of wound care in elderly diabetic foot ulcer: A practical nursing approach

Biography:

Leila Hassani Khodajou has completed his graduation at the age of 25 years from Guilan University of Medical Sciences, Rasht Iran. She completed Postgraduation Studies from Payame Noor University, Tehran, Iran. She is the Supervisor of nursing care services in the Atieh Hospital in Tehran, Iran. She has published more than 25 educational materials in educational bulletins and has been serving as an active educational board member of Iranian Nursing Scientific association.

Abstract

Causes of diabetic foot wound are multiple factors including peripheral neuropathy, decreased blood supply, high plantar pressures. Elderly diabetic foot wound may be a significant risk for morbidity, limb amputation and mortality. There is no conventional guideline regarding the selection of wound care materials in elderly diabetic foot wounds. According to the colors of the diabetic foot wound (Red-Yellow-Black wound) , it may classified in four categories.  Also, grading can be done using Wagner’s or the Texas wound classification system. Anyway, the foot is a complex structure, which acts as a foundation for the whole body, and it is important to prevent progression of diabetic foot problems. Therefore the some specialists play an important role in wound management of diabetic foot including endocrinologist, podiatrist, vascular surgeon, microbiologist, orthotist, and nutritionist. Choice of wound care in elderly diabetic foot wounds may be based on wound healing process, patient status, and anatomical changes in foot. Revascularization, debridement, offloading, antibiotic therapy, and wound care by using dressing. There are more products which help to cleaning of the wound, improve tissue granulation and wound healing. Some of them are Polyurethane films, Polyurethane foam, Hydrogel dressings, Alginate dressings, Growth factors, Honey-impregnated dressing, Topical enzymes and also Mechanical device such as Vacuum-assisted closure which generates a topical negative pressure over the wound bed. The successful management of elderly diabetic foot wounds requires the multidisciplinary teamwork of specialists. There are various topical regimes available, but the choice depends only on the treating physicians, podiatrist, or clinical care nurse.