Archive for the ‘Clinical – Conditions’ Category

 All About the Braden Scale for Predicting Pressure Injury Risk

Monday, February 14th, 2022

As we shifted from “turning Q 2 hours” for positioning our patients to “individualized positioning based on tissue tolerance,” many clinicians were unsure how best to establish a plan of care.

How do we determine the positioning frequency? What is the pressure injury risk for our patients? How can we quantify risk to drive plan of care for positioning?

The Braden Scale for Predicting Pressure Ulcer/Sore Risk is a great tool to assist with those questions.

(more…)

Decoding Foot Wounds: Pressure Injury Vs. Diabetic Foot Ulcer (DFU)

Wednesday, August 5th, 2020

How often have you found yourself in the conundrum of deciding whether a wound on the foot of a diabetic patient is a diabetic foot ulcer or a pressure injury? 

Probably more than once. This is a hotly debated issue among wound care clinicians.

In this post, we’ll dissect the facts and provide a clear understanding of how to differentiate the two types of foot wounds.

(more…)

How to Treat Diabetic Foot Ulcers with a Total Contact Cast

Thursday, October 10th, 2019

There are times when clinicians and patients have done all they can to prevent diabetic foot ulcers, and they still develop.

“The patients who develop a diabetic foot ulcer are the ones who fell through the cracks,” said Don Wollheim, MD, FAPWCA, WCC, DWC, a board-certified surgeon of the American Board of Surgery.

Wollheim has 25 years of experience in general/vascular surgery and 13 years as a wound care specialist and educator. He also is a medical-legal consultant, college science instructor and clinical instructor for the Wound Care Education Institute.

“Once a diabetic foot ulcer develops, it’s essential it is treated aggressively with proven, standardized methods, as 85% of the amputations performed on diabetic patients began as a diabetic foot ulcer,” Wollheim said.

(more…)

Expert Advice on Complete Decongestive Therapy for Lymphedema

Wednesday, October 2nd, 2019

When healthcare professionals treat patients afflicted with lymphedema, some believe not much can be done to provide relief from swollen limbs and pain.

But much can be done to redirect lymph that’s collecting in the wrong place and send it back to the lymphatic system where it belongs, said Denise Richlen, PT, WCC, DWC, CLT, director of program development and area manager in Southwest Indiana for Paragon Rehabilitation in Louisville, Ky.

Millions of patients in the U.S. suffer with lymphedema, Richlen said.

(more…)

Learn about the Cause and Prevention of Diabetic Foot Ulcers

Tuesday, July 2nd, 2019

With more than 30 million people in the U.S. afflicted with diabetes, clinicians are very likely to encounter diabetic patients.

Carole Jakucs

By Carole Jakucs, MSN, RN, PHN

Diabetic foot ulcers occur in approximately 15% of diabetic patients. And if you’re a wound care clinician, you’ll likely find yourself caring for patients with diabetic foot ulcers more often than not.

To learn more about the causes and how to prevent diabetic foot ulcers, we spoke with Don Wollheim, MD, FAPWCA, WCC, DWC, a board-certified surgeon of the American Board of Surgery.

He has 25 years of experience in general/vascular surgery and 13 years of experience as a wound care specialist and educator. Wollheim is also a medical-legal consultant, college science instructor and clinical instructor at the Wound Care Education Institute (WCEI).

(more…)

How to Care for Diabetic Foot Ulcers and Other Diabetic Wounds

Monday, March 4th, 2019

Whether you are new to wound care, or a seasoned veteran, you’ll most likely encounter patients with diabetes on a regular basis. And by far, the most common wounds seen in these patients are diabetic foot ulcers, said Bill Richlen, PT, WCC, DWC, clinical instructor for the Wound Care Education Institute.

According to the American Diabetes Association, diabetes has affected more than 31 million people in the U.S. since 2015.

“In addition to diabetic foot ulcers, diabetics can also get venous and pressure ulcers too,” said Richlen who also owns Infinitus LLC in Santa Claus, Ind., a wound care instruction and consulting company. “Having a diagnosis of diabetes can complicate and delay the healing process of any type of wound.”

(more…)

8 Reasons to Get Diabetes Under Control Now!

Friday, January 12th, 2018

Patients with diabetes are more likely to suffer many serious health issues besides foot wounds and amputations. This makes it imperative that they resolve to get their blood glucose levels under control.

All of the lawsuits I review have a common theme. The plaintiff suffers from a chronic wound and some degree of malnutrition and/or dehydration. I have started to notice that in addition to these problems, the plaintiff also quite often has diabetes. This trifecta of problems leads to pain, suffering, disability, and discontent.

People with diabetes are 10 to 20 times more likely to have a lower extremity amputation than those without diabetes.1 This is a scary statistic compounded by the fact that people with diabetes may not even notice a foot wound developing because they cannot feel it because of neuropathy. A foot ulcer is the initial event in more than 85% of major amputations that are performed on people with diabetes.2 Knowing this should provide enough motivation for patients to get their diabetes under control, but some people need even more reasons. Here are eight more consequences you can discuss with your patients. Hopefully, one will hit home.

(more…)

Diabetic Toenails: Watch for Change

Thursday, February 23rd, 2017

Changes in the diabetic foot can happen fast: here are the signs and types clinicians in wound care need to look for.

As a wound care professional, chances are you’ve treated a number of nail conditions and abnormalities that occur among the general population. But when you’re working with diabetic patients, noticing and identifying variations is even more crucial. This is because change can happen more rapidly in the diabetic foot, and pathologies in diabetic toenails can ultimately lead to skin breakdown, foot ulcerations and infection. So, what causes the nails to change? What exactly should you look for? We’ve got you covered.

(more…)

Diabetic Toenails: Top Tips for Proper Trimming

Friday, November 11th, 2016

Check out these best practices for trimming your diabetic patient’s toenails to help prevent foot ulceration.

Did you know that a whopping 10-25% percent of all patients with diabetes ultimately develop a foot ulcer – a diagnosis that brings a five-year mortality rate of nearly 50%? Consistent foot care, such as regular screenings, footwear assessment and nail maintenance can help prevent ulceration.

You can help diabetic patients with nail maintenance by taking extra care to preserve the integrity of the toenails. This includes keeping the cuticles and surrounding skin intact, and following best practices when trimming the nails. That’s why we’ve put together our top tips for proper trimming.

(more…)

Diabetic Foot Screening Guide

Friday, July 29th, 2016

Five clinical tests for diagnosing loss of protective sensation in the diabetic foot, plus tips on inflammation assessment.

How serious are diabetic foot ulcers? The statistics are sobering:

  • It is estimated that between 10 and 25% of patients with diabetes will develop a foot ulcer in their lifetime.
  • Diabetic foot ulcers precede 84% of all lower leg amputations.
  • The five-year mortality of patients with newly diagnosed diabetic foot ulcers (DFUs) is nearly 50%, and carries a worse prognosis than breast cancer, prostate cancer, or Hodgkin’s lymphoma.

In addition, DFUs are at increased risk for infections and other complications, and continue to be a major cause of hospitalizations and additional healthcare expenditures.  So while patients suffer greatly from DFUs, these chronic wounds are also a huge financial burden on healthcare systems. This is because these same patients spend more days in the hospital, and experience more visits to the emergency room and outpatient physician offices than other patients with diabetes.

(more…)