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Treating wounds associated with decreased sensibility

M D Kerstein, S Polsky

    Ostomy/Wound Management
    |March 1, 1995
    PubMed
    Summary

    Diabetic neuropathic wounds result from decreased foot sensibility, often unnoticed until tissue necrosis occurs. Patient education and primary care monitoring are crucial for preventing foot lesions and amputations.

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    Area of Science:

    • Podiatry and Endocrinology
    • Diabetic Foot Complications

    Background:

    • Neuropathic wounds are a significant complication of diabetes, primarily affecting patients with reduced foot sensation.
    • Patients often remain unaware of the progression of sensory loss and its link to tissue necrosis.
    • Existing treatments for peripheral neuropathy are largely palliative, focusing on symptom management rather than sensory restoration.

    Purpose of the Study:

    • To highlight the challenges in managing neuropathic wounds in diabetic patients.
    • To emphasize the importance of sensory protection and early detection in preventing severe complications.
    • To discuss current therapeutic and supportive strategies for insensate feet.

    Main Methods:

    • Review of current understanding of diabetic peripheral neuropathy and its impact on foot integrity.
    • Analysis of existing pharmacologic treatments for neuropathic pain.
    • Evaluation of the role of orthotics and prosthetics in managing weight-bearing areas.
    • Emphasis on patient education and primary care monitoring strategies.

    Main Results:

    • Pharmacologic interventions like capsaicin and amitriptyline primarily manage painful symptoms of neuropathy.
    • Orthotic devices and specialized footwear offer mechanical support and pressure relief for insensate feet.
    • Lack of sensory feedback impedes early detection of injury and progression of tissue damage.

    Conclusions:

    • Effective management of neuropathic wounds requires a multi-faceted approach combining medical, orthotic, and educational interventions.
    • Proactive patient education and consistent primary care monitoring are essential to reduce the incidence of foot lesions and amputations in diabetic patients.
    • Addressing the loss of sensory protection remains a critical challenge in preventing severe diabetic foot complications.

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