Wound Care: Pathophysiology of Neuropathic Foot Ulcer and Strategies for Management

Running head: WOUND CARE
WOUND CARE
Name of the student:
Name of the University:
Author note:

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Introduction:
The case study of Mrs. Lowe has demonstrated that she has been diagnosed with diabetes
10 years ago and currently she has been presented with foot ulcer in the right medial bunion area.
The ulcer has been developed before 12 weeks but she did not realized, however, due to aching
she has understood the requirement for treatment. Symptoms such as redness, pain, formation of
callus and excessive fluid coming out of the infected area have been found. She has experienced
such foot problem before and administering antibiotics recommended by the GP has helped her.
However, her arterial flow has been found to be normal, but poor glycaemic control is also
noted. The purpose of the assignment is to discuss the pathophysiology of neuropathic foot ulcer,
impact of poor glycaemic control and local pressure on healing and strategies for managing the
poor health condition of Mrs. Lowe. The following paper will focus on the hypothesis that
diabetic people are more prone to foot ulcer due to poor glycaemic control and effective home
based care for diabetes management, treatment of foot ulcer and patient education is helpful to
recover from foot ulcer.
Discussion of the pathophysiology of the diabetes related neuropathic foot
ulcer:
One of the significant complications for the patient with diabetes mellitus or type 2
diabetes is the development of foot ulcers. Various foot disorder such as gangrene, infection and
ulceration have been found to be the major contributing to the hospitalization of the patients with
type 2 diabetes. According to the research of (Amin & Doupis, 2016) neuropathic ulcers
develops as a result of peripheral neuropathy, especially for the patients with diabetes. It mainly
occurs due to the lack of balance between damage of nerve fiber and repair. Such damage of
nerve affects the distal and autonomic sensory fiber and leads to the consequence of lack of

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sensation. The lack of sensation of the pressure points of foot could lead to increased
microtrauma and breakdown of overlying tissues that gradually causes ulceration (Naves, C.
2016). Thus, in case of Mrs Lowe who has been suffering from foot ulcer in right bunion area,
poor diabetes management of can be considered as the risk factor of her foot ulcer. It has been
indicated that symptoms of diabetic neuropathic foot ulcer varies according to the affected
nerves (Volmer-Thole & Lobmann, 2016). The symptoms may include lack of sensation or
numbness or reduction in the ability to feel pain, burning sensation, cramps, lack of reflexes, lack
of coordination or balance and finally some severe foot problems such as foot ulcer (Chammas,
Hill & Edmonds, 2016). The color of the neuropathic foot ulcer may range from red to brown or
black based on the blood circulation of the patient. As found in case of Mrs Lowe, redder ulcer
has indicated normal circulation or arterial flow. In addition, symptoms such as callused skin,
fluid secretion, punched outlook are common. Furthermore, the untreated neuropathic foot ulcer
may lead to the consequence of osteomyelitis (Armstrong, Boulton & Bus, 2017).
Impact of poor glycaemic control on healing and susceptibility to
infection:
In case of diabetes, beside the focus on blood glucose management, diet, medication and
exercise it is necessary to increase awareness regarding infection as well as poor glycaemic
control could affect the immune system and influence slow healing and chronic infection. The
immune system consists of innate immunity and adaptive immunity (Lipsky, Silverman &
Joseph, 2017). Innate immunity is responsible for the first line defense. It alerts the immune
system regarding the invasion of specific foreign element and activates the adaptive immunity
for better response. The adaptive immunity serves to provide protection from infection. The
response of adaptive immunity activates the lymphocytes that contain B cells, T cells and natural