Theory-Guided Nursing Care of a patient Undergoing Above-Knee Amputation for Dry Gangrene Associated with Newly Diagnosed Diabetes and Severe Anaemia: A Case Report from Sierra Leone

Abstract:

Introduction: Diabetic foot complications remain a major cause of lower-limb amputation in resource-constrained settings. This case demonstrates the contribution of theory-guided nursing care to perioperative management of a patient. Case: A 64-year-old woman presented with a non-healing left-leg ulcer following a domestic burn, complicated by gangrene, infection, severe anaemia (Hb 4.3 g/dL), hyperglycaemia (7.2 mmol/L), and severe wasting. Nursing assessment identified impaired tissue integrity, reduced activity tolerance, inadequate nutritional intake, pain, and risk of infection. Guided by Roy’s Adaptation Model, Neuman’s Systems Model, Kolcaba’s Comfort Theory, and Orem’s Self-Care Deficit Theory, the nursing interventions prioritised stabilisation, wound surveillance, transfusion support, nutrition, pain management, infection prevention, mobilisation, psychosocial support, and discharge education. Following above-knee amputation, the stump remained clean and dry, pain was controlled, and rehabilitation was initiated. Conclusion: Theory-guided nursing processes can organise perioperative care and support recovery despite resource limitations.