Associated Anatomy: Bones and Tissue
Nonhealing diabetic wounds are one of the leading causes for hospitalization and amputation. Diabetes is a metabolic disorder that results in an excess of a sugar called glucose in the bloodstream. Metabolism refers to a process where the body breaks down large food particles into smaller molecules that it can use as fuel. Diabetes results in abnormally high blood glucose levels which leads to irreversible damage to blood vessels and smaller capillaries. The vessel damage inhibits the body’s ability to deliver oxygen and nutrition to tissues. As a result, diabetic patients often have a difficult time healing after a traumatic injury, surgery, or infection.
The signs and symptoms associated with nonhealing diabetic wounds are a result of the damaged vessels inability to deliver oxygen to damaged tissue. Many patients complain of pain in and around the area of the wound. The severity of the pain is directly related to the level of oxygen starvation occurring at the cellular level. Other symptoms include, swelling, redness, and increased temperature of the wound. If infection is present, there may be malodorous discharge of pus draining from the wound.
Initially, nonhealing diabetic wounds are treated in an outpatient wound care facility . Care may involve debridement (wound cleaning) with special types of dressings. If infection is present, the patient may be treated with oral antibiotics or hospitalized for more severe cases. Surgery and or amputation may be necessary for some patients. Hyperbaric oxygen therapy (HBOT) is approved for use in patients who have tried the conventional treatments and are at possible risk of amputation. HBOT significantly increases oxygen delivery to damaged tissue and also provides antimicrobial effects against certain microorganisms that do not survive well in a highly oxygenated environment. HBOT also stimulates the growth of new blood vessels (angiogenesis) for a permanent increase in blood supply to tissue.
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