Need help with my writing homework on Diabetes Leading to an Extension of the Inflammatory Stage of Repair. Write a 1750 word paper answering; Diabetes, which is an endocrine disorder, is caused when the cells of the pancreas are unable to produce insulin or there is a deficiency of insulin within the body (WHO 2006). A diabetic foot ulcer is a major complication of diabetes. According to Bowering (2001), foot ulcers in diabetic patients are common and frequently lead to lower limb amputation unless a prompt, rational, multidisciplinary approach to therapy is taken. Diabetic wounds have been described as “complex microcosms of multiple pathophysiologic processes” (Al-Watban et al., 2007, p72 ), and are predominantly characterized by polymicrobial infection, peripheral neuropathy, structural deformity, altered immune function or increased susceptibility to infection, decreased wound nitric oxide (NO) production, and often, hypoxia/ischaemia. Hence, it is important for podiatrists who are involved with wound care management to have a proper understanding of the functional relationships of the biological processes of normal compared to pathological and non-healing ulcers in order to be able to devise treatment strategies. They also need to be aware of all the factors that influence the process of wound healing, especially in diabetic ulcers. The degree of metabolic control, the presence of ischaemia or infection, and continuing trauma to feet from excessive plantar pressure are some of the factors that affect the development and healing of diabetic patients foot ulcers.
According to Grey et al. (2006), most wounds, regardless of aetiology, heal without difficulty. But, at times, certain local and systemic factors can impede the healing of the wound. For example, local factors such as inadequate blood supply, poor venous drainage, infection, foreign body reactions, wound dehiscence can delay wound healing. Some of the systemic factors that hinder wound healing are advancing age, systemic malignancy, chemo- and radiotherapy, impaired macrophage activity and malnutrition.