Can Diabetic Wound Care Be Diagnosed?
Diagnosis of pressure ulcers (“decubitus,” “decubiti,” pl.) and infections and injuries of the feet, lower extremities, and other areas are by inspection. Infection usually is accompanied by odor and a discharge (exudate of purulent secretions). Pressure ulcers in the feet can indicate improper shoe fitting.
Both infected areas and uninfected areas may look the same. The definitive diagnosis of infection is via a culture retrieval from the site and then to test the infectious microorganism against several antibiotics to judge the efficacy of them. This drives the decision of antibiotic choice.
A test for sensation to pain, pinprick, and light touch is necessary to identify problem areas for prophylactic padding.
Peripheral vascular disease may compromise the arterial blood supply to tissues, and an arteriogram can demonstrate areas of poor perfusion. Nerve conduction studies can point out nerve tracts that are not functioning properly.
Diabetes injury occurs because of hyperglycemia, and evaluation of the patient’s glycemic control is done with serial glycated hemoglobin A1c.
Other tests with diabetic injuries should assess the total well-being of the person at risk of cardiovascular, eye, and kidney disease from his or her diabetes. These can be done using ECG, kidney function tests, and a thorough ophthalmological exam.