Gerontological Patient Requiring Surgical Debridement

This article discusses the pathophysiology of diabetic foot ulcers in gerontological patients, evaluation of pharmacotherapy management, and critical analysis of care approach. It also explores the impact of medication on cellular function and the effectiveness of palliative care for patients with critical illness.

Gerontological patient
requiring surgical
debridement

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Pathophysiology.....................................................................................................................3
Evaluation...............................................................................................................................4
Critical analysis and One approach to care............................................................................5
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Pre-operative refers to the service which are provided before the operation that may include
different function and should ensure about some operation they may include medical history,
laboratory tests, chest X-ray and other medical information before the treatment. In this, there is
discussion about the pathophysiological concepts that are related with the given scenario. There
is also discussion about the evaluation of pharmacotherapy management that can affect the
cellular function. There is also discussion about the pharmacotherapy management that includes
medication. There is also discussion about the critical analysis of the provided approach of care
which is effective and can be highly helpful for the patient with foot ulcer and other
complication.
MAIN BODY
Pathophysiology
The pathophysiology of the diabetic foot ulcer has shown the aspect of neuropathic, vascular
and immune system which is based on the system component which is allow used to show the
relationship with the hyperglycemic condition of diabetes. The Hyperglycemia is usually
produce oxidative stress on the different nerve cell that lead to create the neuropathy. There are
some of the additional nerve dysfunction which is used to follow from the glycosylation of the
nerve cell protein, that lead to cause the issue of ischemia (Rosyid and et. al., 2017). These
change on the cellular function are used to manifest in the motor, autonomic and the sensory
concept or the component of the neuropathic foot ulcer. Damage to motor neurons of the foot
musculature which may lead to create the issue of an imbalance which is associated with the
flexor and the extensor, anatomic deformities and the skin ulceration. Moreover, they also used
to damage the atomic nerve that impair with the sweat gland functions and their foot used to
develop and decrease the ability to moisture skin that lead to create the issue with the epidermal
cracks and the skin breakdown. However, the patient used to face critical issue in walking and it
is painful for the longer period. The patient also may not identify the foot wound because the
condition may use to lower the sensation which is related with the peripheral sensation. Because
of the blood supply is required to heal a diabetic foot ulcer that is greater than the needed fraction
which help to maintain the intact the skin chronic ulceration which can be developed and
produced (Liu and et. al., 2019).

Moreover, the vascular changes are also used to show their numerous aspect which lead to
create the complexities with the diabetic foot ulcer that is correlated with the hyperglycaemia
induced change which is associated with the peripheral arteries of the foot and they are begin
with the level of cellular. However, the decrease in the vasodilator are used to related with the
endothelial cell dysfunction. In addition to this, they are also connected with the plasma
thromboxane in peripheral arteries that lead to create the issue with the ischemia and the enhance
the risk of ulceration in the foot which is painful for the longer period. In the age of 72 years, the
healing factor are week and take longer time to health the ulceration. Moreover, they used to
focus on the prevention of infection which may create more issue with the individual at the age
of 75 years (Rubitschung and et. al., 2021).
Moreover, the immune change is also used to involve which is focus on the healing response
which is associated with diabetic foot ulcer. There are number of explanation which is
commented and focus on the aspect of foot ulcer which must be prevented after the analysis of
pathophysiology which is cumulative and follow preventive factor. The enhance T lymphocyte
apoptosis is used to show the aspect which used to inhibit the healing and used to focus on the
observed towards the aspect of patient with the diabetic foot ulcer (Shin and et. al., 2017).
Evaluation
Pharmacotherapy refers to the treatment for a disorder or disease which can effective
medication for any disease. Here, pharmacotherapy management can be effective and allow to
deliver the quality care by delivering of better medication for the improved health. There is high
impact on the cells of the patient which can lead to impact body due to higher age (odd and et.
al., 2018). Here, pharmacotherapy management is highly effective and through providing
medication, this can impact the human cells and interface the microorganisms like germs which
invade within body. This can destroy abnormal cells that can cause cancer within body and help
to replace deficient substance like vitamins and hormones. This can also impact the working of
cell they way of their work within body. There are various drugs which may impact and
influence the function and structure of specific functional components of the cell membrane.
There is various function that may include receptor-mediated reactions or enzyme systems
(Gebauer and et. al., 2017). Through changing and impacting the working and removing the
unwanted cell from body are some of the effective which may cause due to pharmacotherapy
management. When there is use of medication for longer and with high concentration then there

is risk of accumulation that may disorganize overall membrane structure. This can impact the
embedded proteins like ion channels, enzymes or receptors. Mr. Bitton is 72 years old and due to
high consumption of drug may impact on the body cell of the patient. There can be risk of not
getting proper distribution of drug which may impact the patient. Here, Becaplermin (Regranex)
Becaplermin gel 0.01% which is generated through the genetic engineering can help to delivery
better help and pharmacotherapy management for the Mr. Bitton in the diabetic foot ulcer
(Seferovic and et. al., 2019). This can be effective and allow to deliver quality care for the
patient. Here, pre-operative point of pathway can be effective where it is necessary for the
providing better health. In this, through the pharmacotherapy management through providing
medication can be effective and allow to deliver better and effective service delivery. Through
the help of pre-operative management, healthcare professional is able to deliver the better
treatment and through pharmacotherapy management they may help Mr. Bitton to get better
improvement in their foot ulcer where medication should be delivered by ensuring about the
pharmacological impact and other complication. Through this pharmacotherapy management,
healthcare professional is able o delivery the quality treatment through the medication which
allow to improve the condition of foot ulcer in Mr. Bitton (Kallio and et. al., 2018). There is high
impact of medication on cellular function which may impact through removing the unwanted
cells and providing safety from the cell which can create the risk of cancer within body. This is
one of the relevant pharmacotherapy which is effective and allow to deliver better care and
treatment for the patient.
Critical analysis and One approach to care
As per the review of case study, Mr. Bitton is 72-year-old and he also faced various critical
issues which is related with the healthcare. In this, as per the review of disease history he is
dealing with the various issue which may create life threatening aspect for the Mr. Bitton. Some
of the disease are critical that mainly include ischaemic heart disease which is diagnose 3 year
ago. Moreover, the condition is stabilised with the help to moderate exercise. As per this, he is
also face the situation of peripheral neuropathy with the reduced sensation of mid-calf bilaterally.
Therefore, other associated disease that is linked with Mr. Bitton is chronic disease which is
diagnose the 2 year ago that is determined as the stage of 3. Moreover, from the all the aspect
they need to take palliative care and support from the hospice care. The disease is completely
dominant on the Mr Bitton and with this age, it if difficult and partially impossible to take fight

against with these all condition. With the contrast of medical condition, Mr. Bitton require only
palliative care. As per this, the palliative care is group of team which is usually focus on those
individual who is facing the issue of critical illness and they only want to extend their life with
the slow progression of disease (Yarahmadi and et. al., 2021).
To provide better healthcare services there is need to ensure about applying the approach of
care which can be more appropriate for the individual patient. Here, some of the approach that
can be effective for the better and effective improvement in health. This approach to care
includes curative, preventative, rehabilitative and palliative care. In this, there is need to ensure
about the effective care that can allow for the better and effective care for the patient.
Here, curative care refers to the curative medication which are effective and allow to deliver
healthcare for the given medical condition that should be provided and considered for achieving
the better outcome. This is different form the preventive care that can prevent diseases
appearance using pharmaceuticals like immunization techniques, proper eating habits, exercise
other life style issues (Radbruch and et. al., 2020).
Here, through proving the palliative care, healthcare professional is able to provide
optimization in quality of life which can help to expand the life for longer. This is provided to
the people who are effective and can help to mitigating suffering within Mr. Bitton with the
serious illness and various complication due to different diseases and older age. Here, this can be
helpful in providing quality of life that help to expand the live expectancy within patient.
CONCLUSION
From the above discussion, it can conclude that there is need to ensure about the pre-
operative point of pathway which can impact the delivery of care services to the patient with
higher age. Through specific pathophysiological concept, that are interrelated with the patient. In
this, there is discussion about the pathophysiological concept that can allow to deliver quality
care and treatment. There is evaluation of the pharmacotherapy management that can include
medication for the better treatment. This can allow to deliver better health treatment which can
provide better positive impact. There is also discussion about the critical analysis of the car
approach which includes the palliative care. This provide better healthcare treatment that help to
improve the quality of life for better outcomes.

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