Diabetic Wounds and Debridement

What is the appropriate term to describe the right diabetic foot?

• Dyshidrosis

• Glycosylation

• Charcot Arthropathy

• Crusty

How long is the "Golden Hour for the Diabetic Foot"?

• 4 hours

• 4 days

• 4 weeks

• 4 months

Answer explanation

• “Patients in whom ulcer size fails to reduce by half over the first 4 weeks of treatment are unlikely to achieve wound healing over a reasonable period”

• 200x greater risk of infection in wounds progressing beyond 4 weeks

• 155x greater risk of amputation in wounds developing infection

What is a common wound care treatment for a neuropathic wound but not an arterial wound?

• Treatment of infection

• Dressings with appropriate moisture management

• Sharps debridement of callus and necrotic tissue

• ABI

What is the Gold Standard for off-loading a diabetic foot wound?

• Total Contact Casting

• Off-Loading Devices

• Toe Crest Pads

• NWB with an appropriate AD

True or False: Standard Rocker Bottom shoes are an appropriate option for long-term footwear for someone who has diabetic foot ulcers

• True

• False

Answer explanation

False: Diabetic shoes are imperative. Diabetic shoes have extra depth, total contact molded inside and a rocker bottom

True or False: Diabetic shoes require a physician prescription.

• True

• False

Glycosylation has what effect?

• Charcot Athropathy

• Hypermobility

• Stiffening of connective tissue

• Dishidrosis

Answer explanation

Glycosylation is an enzymatic process caused by the presence of a sugar molecule and long term hyperglycemia → glucose reaction with protein to form irreversible collagen cross links → general stiffening of connective tissue.

• Prayer sign: looks for ability of patient to place palms of hands together with full contact of palms and fingers

• Dorsiflexion ROM loss

• Hammer toes.

Which of the following is not an indication for debridement of a wound?

• Remove necrotic tissue

• Determine extent of wound

• Reduce bioburden

• Increase cellular senescence

Answer explanation

Cellular senescence: Chronic wound cells become less responsive to chemical factors that provoke healing. Debridement will REDUCE this.

True or False: This wound is appropriate for sharps debridement.

• True

• False

Answer explanation

Dry, stable eschar on the heel is appropriate to leave intact and protected. It serves as a barrier against infections.

Sharps debridement is an example of what type of debridement

• Selective

• Non-Selective

• Autolytic

• Enzymatic