Identify three potential problems that Miss Brown may encounter. Provide rationales for your answers
Miss Brown is scheduled for a right below-knee amputation on tomorrow's list. She weighs 120 kg, is 160 cm tall and has type 2 diabetes.
What will be an ideal response?
Answer:
Delayed or poor wound healing due to necrotic tissue. Dead, devitalised (necrotic) tissue can delay healing. Slough and eschar are the two types of necrotic tissue that may appear in a wound. Given that this is an amputation, there is a high likelihood of necrotic tissue. A proper level of oxygen is also crucial for optimal wound healing. There is impaired vascular flow causing poor tissue oxygenation
A compromise in wound healing due to obesity - poor blood supply to adipose tissue. In addition, some obese patients have protein malnutrition, which further impedes healing.
High risk of postoperative infection due to peripheral vascular disease with impaired leucocyte function. Aseptic technique is vital to reduce the risk of a postoperative infection.
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