Cased based essay- Treatment, rationale and management of the iskemic Essay

Cased based - Treatment, rationale and focussing of the iskemic ulcer - Essay ExampleOther important findings in the annals include presence of intermittent claudication of the left lower limb since one year. John is a chronic smoker. He decrease smoking since one year after onset of claudication symptoms, following advice from a physician. However, he has non been able to completely quit smoking. During the current visit to the hospital, there is no history of fever or whatsoever other symptoms. The patient complains that the onset of ulcer started after he began to wear new don shoes with narrow toe box. The patient reported being allergic to penicillin. There is no history suggestive of occupational injury, trauma, varicose veins, previous history of lower limb wounds/ulcers/gangrene, history of amputations and history of any other surgeries. There is no family history of similar ulcers either. The patient is not suffering from any collagen diseases. He is not on any anti-in flammatory drugs or steroids.The condition of the patient is stable. He is afebrile. He looks well nourished. Vitals signs are stable. Systemic examination is within normal limits. The ulcer is located over the askance malleolus of the left leg. The size of the ulcer is 3cm in length, 2 cm in width and about 0.5 cm in depth. The borders are regular and the wound appears punched out and clean. The color of the ulcer is yellowish. There is minimal granulation tissue tissue. The exudate from the ulcer is mainly serous and minimal. The surrounding skin appears pale, non-edematous, shiny and has decreased hair. Dorsalis pedis pulsation appears normal. demoralise extremity ulcers are very common in patients with diabetes and infact, these are the most common causes for limb amputation in diabetic population (Armstrong and Lavery, 1998). Factors which contribute to the development of ulcers in the diabetic population are diabetic neuropathy, fringy arterial disease and structural defor mity (Armstrong and Lavery, 1998). From a podiatrician perspective, it is very