Realise the depth and extent the infection alter the type treatment

Mrs. Gina Bacci is a 49-year-old Italian female. Medical history of Gina reveals that she was consistently obese with a BMI 40.4. She was diagnosed with Type 2 Diabetes six years ago, insulin doses were recommended to control the blood glucose levels. A history of Peripheral vascular disease involving the weakened vasculature in the extremities and insufficient blood circulation has been noted. She developed a diabetic foot ulceration and required the forefoot amputation along with the great and first toes. Post-surgery the prescribed medication included NovoRapid an insulin analogue to substitute the lack of insulin production. Pain in surgical patients is addressed through a multifaceted approach using analgesics Paracetamol 1g QID, and neuropathic pain due to the damaged nerves is treated with Pregabalin, Lantus a long-acting insulin analogue with an improved glycaemic control in adults is included as a part of treatment regime. It is considerably safer as the glucose levels are consistent(Delgado & investigators, 2012)

Diagnosis of post-operative condition:

In the current case, patient has a clinical history of peripheral vascular disease and maybe the probable cause of impeded wound healing. The surrounding skin of the surgical wound is warm indicative of perfusion, and dark pink representing the proliferative phase of wound healing and painful to touch.

Nursing priorities:

Safe nursing management:

Active task handled by nurses with an intention and aimed at the patient better health outcome can be defined as nursing intervention. Nursing interventions are based on the nursing assessment i.e, diagnosis of the medical condition of a patient To establish effective wound management an extensive assessment reflecting the wound characteristics is required. With the clinical history in mind, the next stage is to ascertain the phase of the wound repair.

The features of an ideal wound dressing as a part of nursing interventions are:

a) Moisure environemnt

h) Sterilization is important to prevent further secondary infection, non-toxic and non-allergic(Dhivya, Padma, & Santhini, 2015).

Traditional methods had Gauze dressings made out of cotton, rayon, polyesters. They were not effective against the risk of infection. They absorb the exudate well and require constant change of the dressing. The major disadvantage of these dressings is that they become moistened and adhere to the wound rendering it difficult to remove. Xeroform (non-occlusive dressing) with 3% of Bismuth tribromophenate is a standard for non-exuding to slight exuding wounds.

Delgado, E., & investigators, L. S. s. (2012). Outcomes with insulin glargine in patients with type 2 diabetes previously on NPH insulin: evidence from clinical practice in Spain. International journal of clinical practice, 66(3), 281-288. doi:10.1111/j.1742-1241.2011.02880.x

Dhivya, S., Padma, V. V., & Santhini, E. (2015). Wound dressings - a review. BioMedicine, 5(4), 22-22. doi:10.7603/s40681-015-0022-9

Shanmugam, V. K., Fernandez, S. J., Evans, K. K., McNish, S., Banerjee, A. N., Couch, K. S., . . . Shara, N. (2015). Postoperative wound dehiscence: Predictors and associations. Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, 23(2), 184-190. doi:10.1111/wrr.12268