Neuropathic Ulcers: Diagnosis, Treatment, and Role of Health Professionals

This report provides an overview of neuropathic ulcers, including their diagnosis, symptoms, treatment options, and the role of health professionals in managing them. It focuses on the impact of neuropathic ulcers on diabetic patients and the importance of early identification and treatment.

NUROPATHIC
ULCERATION

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
Defining the condition.................................................................................................................3
Typical features of the condition, signs and symptoms...............................................................3
Diagnosis.....................................................................................................................................4
Clinical course of action and prognosis.......................................................................................4
Treatment options that is available..............................................................................................5
Role of health professionals.........................................................................................................5
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Neuropathic ulcers are a very common disease amongst the diabetic patients specifically
(Armstrong, Boulton & Bus, 2017). In this report the overall diagnosis, symptoms, treatment and
role of professionals in the process of treating the neuropathic ulcers will be identified and
analysed effectively.
MAIN BODY
Defining the condition
The situation of neuropathic ulcers is defined as the one where the person loses the
protective sensation. It is due the peripheral neuropathy and then it leads to the repetitive stress
causes, the injuries that a person does not even notice and ultimately, these lead to the creation of
painless ulcers that lead to the formation of pressure points on the limb (Chammas, Hill &
Edmonds, 2016). These kind of neuropathic ulcers are usually developed in the diabetic patients
and the pressure points of the limb are the most affected area. It breakdowns the overlying tissue
and then the formation of ulceration occurs.
Typical features of the condition, signs and symptoms
Typically it can be categorized that the neuropathic ulcers features the disturbance in the
sensory nerves that are responsible for the detection of different sensations such as pain, changes
in temperature, heat cold etc. and the motor nerves also get affected of the patient leading to the
muscle wasting, foot deformities etc. (Leo, Burde & Almeida, 2019). The ulcers of such kind are
more prone to occur at the common pressure points in an individual such as the plantar, hallux or
metatarsophalangeal joint etc. The major symptom of this disease includes the following aspects:
 The neuropathic ulcers vary from the colour of red to brown or black based on the blood
circulation in an individual.
 The wound caused due to neuropathic ulcers are well defined and have a punched out look
where the skin surrounding it is often calloused.
 There is an undermining in the wounds and this can often lead to the creation of infection
that can affect the bone or the bone marrow (Van Bael & et.al., 2016).
 The wound would be painless for the individual but the harm that it will create will be
surpassing beyond cure if left untreated.
 The integration of the restricted blood supply i.e. ischemia and the neuropathy can lead to
the escalated impact of the infection very quickly.
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 The pulse can be normal of the limb where the wound has merged thus excluding the
supplementary circulatory components towards the ulcer.
Diagnosis
The diagnosis is possible only when the caretaker has the knowledge of the risk factors that
are associated with the neuropathic ulcers. Physical examination that is conducted extremely
carefully and includes the test for monofilament testing in order to identify the neuropathy and
the non invasive testing in order to test the arterial insufficiency are sufficient to diagnose the
neuropathic ulcers. The diabetic patients should undergo through a foot examination at regular
intervals so that the development of any neuropathic ulcers can be identified as quickly as
possible (Kobyliak & et.al., 2019). The diagnosis is critical in early identification and treatment
of the neuropathic ulcers effectively thus making it mandatory to use corrective actions.
Checking the blood glucose levels, the investigations of any deep infections that might have
developed i.e. doing x-ray, assessing the peripheral neuropathy are some of the assistive actions
that should be adopted in order to analyse or diagnose the neuropathic ulcers more quickly and
accurately.
Clinical course of action and prognosis
The clinical course of action that can be adopted includes the first stem where the wound
that has developed should be thoroughly debribed (Raad & et.al., 2018). The process of
debribation includes the removal of all the infective undermine of layers that surrounds the
wound and the wound should be debribed to a healthy and bleeding tissue. The activity of
debribing will provide better healing environment and also help in the better assessment of the
ulcer that has developed i.e. its specifications can be easily developed in a more accurate manner.
The prognosis includes the ensuring that the wound that the patient has developed is moist but it
is also able to breathe i.e. there are no layers of infectious undermining or any callousness that
surrounds the wound which can slow down the recovery or even worse, it can lead to the further
infections and complications in the patients. It is therefore necessary to ensure that the dressing
that is used to treat the wound of the patient is changed on a regular basis and further the
dressing should be in accordance with the specifications of the wound that has such developed
due to neuropathic ulcers (Benito & de la Viuda, 2016). Hence the prognosis and the clinical
action that is required to treat the neuropathic ulcers mainly include the regular dressing and
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keeping the wound clean and healthy so that the recovery of the ulcer that has been developed is
quicker and more prominent avoiding any formation of additional infections as well.
Treatment options that is available
In order to develop a comprehensive remedy for the treatment of the neuropathic ulcers,
there are certain measures that can be adopted and the most prominent aspect is that the pressure
on the area that has been affected by the neuropathic ulcers should be reduced (Killeen & et.al.,
2018). Since the wound is critical and cannot be interfered with, it is necessary to reduce the
amount of pressure to a minimum. However, it is also necessary to develop a proper balance
between the reduction in the pressure and the circulation of the extremities as well so that the
recovery can be quicker. Therefore, excessive bed rest is not a recommended step in the
treatment of the neuropathic ulcers. The use of the contact casts is the most prominent step that
can be suggested so that the pressure can be decrease and at the same time the patient is also able
to remain in an ambulatory position. The next step is to use proper footwear i.e. the use of the
therapeutic shoes is also the highly recommended treatment material. However, the use of these
shoes is more appropriate in the avoidance of the recurrence rather the use for treatment (Skoutas
& et.al., 2018). A patient is recommended to use these so that the re- occurrence of the ulcer can
be avoided. These are the recommended treatment options that should be adopted by the medical
professionals who are engaged in the treatment of neuropathic ulcers patients.
Role of health professionals
The role of health professionals basically extend to the daily dressing of the neuropathic
ulcers i.e. the wounds that the patient has developed, checking their vitals, the evaluation of the
progress in the recovery of the wound. Further the patient might also require the additional
support in movement on the initial few days of the treatment of the wound especially if it is
comparatively much deeper (Conde‐Montero & et.al., 2016). The role of podiatry professionals
can be immense in the recovery process of a patient especially if they are sportsmen. The
podiatry professionals can be the first persons to recognise the formation of the neuropathic
ulcers wound and that can even lead to the better treatments. The podiatry professional usually
maintain or examine the wound in a much focused manner where communication is the key to
healing. The podiatrists can effectively contribute in the care taking aspect of the patient and they
can overall quicken the healing process and help in maintaining the peace that is desired in the
recovery of the patients.
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CONCLUSION
The research conducted above shows that the neuropathic ulcers can be cured very easily
with a proper care routine and better healthcare regime that should be adopted.
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REFERENCES
Books and Journals
Armstrong, D. G., Boulton, A. J., & Bus, S. A. (2017). Diabetic foot ulcers and their
recurrence. New England Journal of Medicine. 376(24). 2367-2375.
Benito, M. Á. A., & de la Viuda, S. E. (2016). Microbiota, Biochemical Enviroment and Clinical
Management of Neuropathic Ulcers. JSM. 4(1). 1029.
Chammas, N. K., Hill, R. L. R., & Edmonds, M. E. (2016). Increased mortality in diabetic foot
ulcer patients: the significance of ulcer type. Journal of diabetes research, 2016.
Conde‐Montero, E., & et.al., (2016). Neuropathic ulcers in leprosy treated with intralesional
platelet‐rich plasma. International wound journal. 13(5). 726-728.
Killeen, A. L., & et.al., (2018). Fully Synthetic Bioengineered Nanomedical Scaffold in Chronic
Neuropathic Foot Ulcers. Wounds: a compendium of clinical research and
practice. 30(10). E98-E101.
Kobyliak, N., & et.al., (2019). Neuropathic diabetic foot ulcers treated with cerium dioxide
nanoparticles: A case report. Diabetes & Metabolic Syndrome: Clinical Research &
Reviews. 13(1). 228-234.
Leo, L., Burde, J., & Almeida, V. R. D. (2019). Comparative analysis of clinical features and
radiological outcome of neuropathic ulcers in a diabetic foot. International Journal of
Orthopaedics. 5(1). 38-43.
Raad, M., & et.al.,. (2018). AB234. 28. Primary results of bone biopsies in outpatients with
neuropathic ulcers—comparison with wound swabs and superficial tissue samples.
Skoutas, D., & et.al., (2018). Osteomyelitis and Neuropathic Ulcers in Forefoot—Amputation Is
the Only Surgical Intervention Resolving?.
Van Bael, K., & et.al., (2016). Gastrocnemius fascia release under local anaesthesia as a
treatment for neuropathic foot ulcers in diabetic patients: a short series. Acta Chirurgica
Belgica. 116(6). 367-371.
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