Pilonidal Sinus Wound Management Care plan

The patient also has non-insulin dependent diabetes mellitus (NIDDM) that requires him to have a controlled diet. He is also hypertensive and has a history of hemochromatosis. At a weight of106 kg and a height of 169 cm, this patient is also obese. The patient, alongside the regular attendance of the wound, is adhering to diabetic diet and medication. He is also on hypertensive. Diabetes adverse effect on wound healing is multifactorial. Importantly, diabetes lowers the body’s ability to fend off infection. Secondly, diabetes mellitus alters tissue repair by impairing the biochemical, metabolic and cellular processes involved in wound healing resulting in delayed wound closures (Okonkwo& DiPietro, 2017). In people with diabetes, macrophage activity responsible for initiating tissue repair is suppressed (Okonkwo& DiPietro, 2017).

The patient’s prolonged healing is consistent with inadequate diabetes mellitus management. Obese persons are vulnerable to pilonidal disease due to the wet and fragile skin caused by over-sweating and the tendency to have a more deeply positioned intergluteal cleft. Pathophysiology Pilonidal sinus may manifest an inflammatory condition, usually chronic, that mainly appears on the sacrococcygeal area. Pilonidal sinus may be seen as an abscess that drains to the skin or even as a lesion that extends to the perineum (Duman, 2016). This is consistent with the client’s complains. Sometimes, the abscess may get infected by such anaerobes as E. Pharmacological treatment and pharmacodynamics The patient is already on diabetes and hypertension management medication. He is on Diabex (Metformin) that he takes at night, two 500mg tablets, a regime that is prescribed for the control of blood sugar in diabetes mellitus patients.

Diabex is especially the drug of choice for patients who are also battling obesity that is proving hard to manage exclusively by diet and exercise. The antihyperglycemic Metformin acts by improving insulin sensitivity through enhanced peripheral glucose absorption and utilization while also suppressing glucose uptake in the gut (Rena et al. For hypertension management, the patient is on Avapro (Irbesartan). The depth and the size of the wound should be noted during each of the three weekly assessments. The assessment should also include measuring the length of the sinus which should also be documented. This should allow monitoring of prognosis as the wound progresses through the healing process. The care plan will also ensure proper cleansing of the wound by a specialist or the client.

Notably, the wound, being close to the anus is at quite a high risk of infection due to bowel movements (Brown, 2017). As already noted, the wound should be dressed in each of the three visits every week. Importantly, the dressing material should be comfortable to the patient and also ease the process of changing so that even the patient can change it. Finally, the patient will be helped and encouraged to become as self-reliant as possible in the wound healing process. Engaging the patient to be part of the care plan leads to positive outcomes. For instance, the patient should be assisted to understand the essence of timely and scheduled dressing changes, the importance of constantly hydrating and observing proper nutrition especially during the period of wound healing.