Osteomyelitis is a common infection of the foot associated with diabetes. In most cases, osteomyelitis occurs when there are non-healing ulcers in the foot. It begins as a soft tissue infection that advances to the bone. The infection first attacks the cortex and later the bone marrow. The ulcer should be well examined in relation to where it is located on foot, its size, how deep it is, the content of the wound and the area surrounding the wound (Malhotra, Chan, & Nather, 2014). The immunity of a diabetic person is compromised, making them more susceptible to infections. When infections occur with diabetes also makes making slow and sometimes hard. When osteomyelitis is not well monitored and treated, it can lead to amputation of the limb.
Some of the identified changes with the patient include a non-healing foot ulcer. The footsore seems to be recurring and needs constant draining and dressing. The patient has made frequent visits to the doctor’s office over the last couple of months. After assessment it is clear the patient also does not eat a balanced diet as recommended by the nutritionist, but instead is a regular consumer of processed and junk food. It is also important to note that the patient does not have an active lifestyle. All the mentioned characteristics promote the growth of the foot ulcers and hinder their healing as high blood sugars hinder the immune system from performing its duties and there is increased inflammation of the body cells.
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The intervention given to the patient can be modified through the implementation of the conservative form of treatment that involves the use of antibiotics to treat the sore on the feet. With the patient following up on all the recommendations of the doctor and adhering to a balanced diet then the ulcers are expected to clear. However, if the ulcer is persistent and continues to grow, operative form of management may be inevitable (Giurato, Meloni, Izzo, & Uccioli, 2017).
There are factors that influence wound healing. The factors are categorized into local factors and systemic factors. Local factors include oxygenation, which is influenced by hydration, infection, and the presence of foreign bodies among others. Systemic factors include age and gender of the patient, hormones, stress, obesity, poor nutrition and presence of some diseases in the body such as diabetes. Age affects wound healing by delaying the process as physical changes occur in the body as a result of growing old. Poor nutrition deprives the body of nutrients crucial for healing a wound while dehydration impairs movement of cells and reduces amount of oxygen in the blood.
The treatment of the patient will not be modified immediately. The patient will be discharged with the first regimen of drugs, and upon coming back for review, the healing process will be assessed, and them change of treatment regimen can be considered. Some genetically ill patients have genetic predisposition contributing to the chronic infection. There is a proportion of patients that refuse care. Refusal of treatment can be of different level complete refusal or partial refusal. The level of knowledge is crucial to ensure that patients have all the information necessary before they make any medical decision.
The issues related to factors associated with chronically ill patients can be addressed by providing health education to the public. Ensuring people eat a balanced diet and they are involved in an active lifestyle. It is important to understand that not all genetically susceptible individuals will develop a particular condition in their life. Acute care is medical care that is targeted on diseases that take a short time to present and usually have a short period of illness while chronic medical care is focused on pre-existing diseases that as usually long term or one may have them for life.
References
Giurato, L., Meloni, M., Izzo, V., & Uccioli, L. (2017). Osteomyelitis in diabetic foot: A comprehensive overview. World J Diabetes, 8 (4):135-142. doi: 10.4239/wjd.v8.i4.135.
Malhotra, R., Chan, C. S., & Nather, A. (2014). Osteomyelitis in the diabetic foot. Diabetic foot & ankle, 5 , 10.3402/dfa.v5.24445. doi:10.3402/dfa.v5.24445
