Diabetic Foot Injury: Wound Management and Assessment Plan

Running Head: Diabetic Foot Injury
Wound Management
-Diabetic Foot Injury
Name of the Student
Name of the University
Author Note

1Diabetic Foot Injury
1. Diagnosis of the chosen individual:
a. Presenting Problem:
The given scenario involves an elderly (70 year old) male patient, Mr X (name
withheld) suffering from Diabetic foot injury. The patient has a large wound on the left
great toe and under the heel, and is accompanied by bleeding (from the injured site)
and pain in the left foot. The wound is also accompanied by swelling and discharge
of exudates, and a bad smell. The wound is on the plantar and lateral aspects of the
foot and toe.
b. Other Medical Conditions:
The patient has a history of Diabetes type 2, as well as hypertension, obesity and
renal dysfunction. The patient also suffers from terminal neuropathy, which was
caused due to Diabetes, and has resulted in a reduced sensation in the lower
extremeties such as the foot.
c. The type of wound and how it occurred
The patient experienced an accidental injury to his left foot while walking.
However, due to his terminal neuropathy caused by Diabetes, he never felt the
injury, and subsequently led to the infection of the wound, bleeding and pain
(Feldman et al., 2017). The injury was aggravated by the improper foot protection
worn by the patient at the time of injury.
2. Evaluation of the wound
a. Wound bed status:

2Diabetic Foot Injury
The wound bed is dark red in color, and bleeds upon contact. The wound shows
signs of unhealthy granulation and infections. The wound bed is also covered with
necrotic tissue, which produces a pus like exudate, and produces a rotting smell.
b. Wound measurements:
The 2 inches in length and 1 inch wide, and 0.1inch deep
c. Condition surrounding skin
The skin surrounding the injury shows a discoloration, and swelling. The peri
wound skin also shows signs of maceration and excoriation. The skin is however
intact around the wound.
d. Wound exudates
The wound also produces brownish yellow exudates, and is accompanied by a
putrid smell. The exudates are also sticky in nature, with high viscosity, and contain
necrotic materials.
Wound Type Diabetic foot ulcer
Location
plantar and lateral aspects of the foot and toe (left
foot)
Dimensions (length, width, depth) 2inch, 1 inch and 0.1 inch
Stage 3
Exudate amount Heavy
Exudate type Serous
Odour Offensive
Colour of wound and surrounds Dark red
Surrounding skin discoloured, inflammaed, intact
Present on admission (yes/no) Yes
Pain in dressing change Constant
Pain Severety 7
Table 1: Wound assessment; Source: (Greatrex‐White et al., 2015; Logan,
2015).

3Diabetic Foot Injury
3. Actual or potential impacts of the wound:
Due to the nature of the diabetic foot injury and ulceration, the life of the patient is
affected by different factors caused by the injury/ulcer, such as:
A. Effect on the quality of life
The diabetic foot injury have resulted in a drastic reduction in the quality of life of
the patient, due to a loss of mobility (as the patient finds it increasingly difficult to
move about because of the foot injury) and thus perform simple activities like leisure
activities, and socializing with others. The patient is no longer able to meet his
friends or go on walks with his wife. This has also made the patient more irritable
and depressed (Pickwell et al., 2017).
B. Pain
The chronic pain associated with the injury/ulcer has also made the patient over
cautious to walk, and the constant pain has also made it difficult for the patient to
focus on anything or enjoy anything properly. The pain has also resulted in anxiety
and irritability exhibited by the patient. The patient also is unable to perform the
activities of daily living due to the pain.
4. Physiology of the healing process and how different factors impacts the
process
Healing of a wound is a complicated process that occurs in several stages,
that involves the process of blood clotting in which activated platelets and fibrin in the
blood produces a blood clot on the wound, followed by an inflammation phase where
white blood cells destroy the cellular debris and releases various growth factors.
These growth factors then cause proliferation of the cells, which promotes the growth