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Wound Care Techniques
Despite years of research and consistent data gathering, diabetes remains the disease with an incredibly high death toll. According to the global data provided by WHO, 15,000,000 people died of diabetes in 2012 (World Health Organization, 2015). However, apart from its direct effects, such as the increase in the possibility of having a stroke, a cardiovascular disease, etc., diabetes also triggers comorbid issues, and ulcers are one of them. As a rule, the identified problem manifests itself in the form of foot ulcers (World Health Organization, 2015). Therefore, the choice of the tools for testing the severity of the wound is crucial in managing the needs of patients with diabetes. However, the choice of the approaches to the process is not very numerous; furthermore, the current strategies have their disadvantages, which means that a superior tool needs to be identified.
Indeed, patient outcomes depend heavily on the choice of the testing tool. Unless an efficient framework for detecting the development of foot ulcers is designed, the patient is likely to develop the comorbid issue that will increase the length of their stay. Consequently, the possibility of the treatment process extending, as well as the contraction of nosocomial infections in the hospital environment, is increased exponentially. Thus, choosing between the available testing options, particularly, the Pulse-Volume Recording (PVR) vs. Ankle-Brachial Index (ABI) techniques is crucial to the overall treatment effect.
Pulse-Volume Recording (PVR) vs. Ankle-Brachial Index (ABI)
The PVR technique has been used as the method of detecting the development of pressure ulcers in diabetic patients for quite a while. The approach involves determining the width of the pulse, as well as the change thereof. Furthermore, the loss of a dicrotic notch (TASC II) is also viewed as a symptom of a problem that needs to be addressed. Therefore, the information obtained in the course of the testing process is used as the foundation for the further design of the appropriate strategy for managing the ulcer (Roth-Albin et al., 2017).
The ABI tool, in its turn, also provides a rather efficient way of determining the threat or a presence of a pressure ulcer. By its design, the test involves the measurement of the arm and ankle systolic blood pressure levels. Dividing the latter by the former, one will receive the information about the vascular function of the patient; as a result, the possible prerequisites for the development of pressure ulcers can be determined at the earliest stage of the problem development and addressed accordingly.
It should be noted, though, that the identified approach implies that the test results should be affected by arterial calcification. In other words, the higher the levels thereof are, the less credible the test results may be (Alvaro-Afonso et al., 2015). Therefore, the identified framework also has its limitations. Nevertheless, the two approaches need to be compared so that the superior one could be determined. Thus, the quality of care for patients with diabetes, particularly, the management of their wounds, can be improved significantly. As a result, the foundation for a rapid increase in the quality of life among the target population can be built successfully.
The research question, therefore, can be put in the following way: In detecting the possibility of a pressure ulcer in patients with diabetes, does the PVR test allow receiving more accurate results than the ABI testing framework?
References
Alvaro-Afonso, F. J., Lazaro-Martinez, J. L., Aragon-Sanchez, J., GarcÃa-Morales, E., Garcia-Alvarez, Y., & Molines-Barroso, R. J. (2015). What is the clinical utility of the Ankle-Brachial Index in patients with diabetic foot ulcers and radiographic arterial calcification? The International Journal of Lower Extremity Wounds, 1(1), 1-5. doi:10.1177/1534734615596906
Roth-Albin, I., Mai, S. H. C., Ahmed, Z., Cheng, J., Choong, K., & Mayer, P. V. (2017). Outcomes following advanced wound care for diabetic foot ulcers: A Canadian study. Canadian Journal of Diabetes, 41(1), 26-32. doi:10.1016/j.jcjd.2016.06.007
World Health Organization. (2015). Global report on diabetes.
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