Preventive Podiatry (foot care)

Preventive Podiatry (foot care) Preventive Podiatry (foot care)

What is an at risk foot?

At risk foot refers to a condition where there is an excess risk of formation of foot ulcers or injuries in a patient with long-standing diabetes.

There are three main ingredients for classifying a foot as being at risk: 

  • Loss of protective sensation
  • Deformity
  • Low arterial blood flow

Presence of two out of these three factors will classify effort as being at risk. 

  • Daily foot examination to look for any injury or inflammation
  • Wearing appropriate footwear at all times that can prevent all solutions
  • Periodic preventive podiatric to remove calluses, trim overgrown nails, excising small ulcers etc

What is the purpose of diabetic foot exam?

The purpose of daily foot examination in diabetes is to uncover any infection or tissue damage that may be happening in a patient with diabetic foot. This is very important for patients with loss of protective sensation or unable to sense whether there is any damage to the foot. The best way to perform the diabetic foot examination is in daylight with the foot in a dependent position i.e. with a person who is not lying down in the bed but seated in a chair. The person who is examining the foot should look for any redness, any local rise of temperature i.e. any area of the foot which is appearing warmer than usual. Gently feeling various parts of the foot to see if there is any painful area is also important. Moving the ankle joint through its range of motion and the various toes through its range of movement is also important.

1-2 minute examination is done on a daily basis, so that the care-giver can actually identify any ulcer. For example, an area of thickening of skin with surrounding redness could mean that this area could become ulcerated very soon. Contrary to popular belief it is important to check the feet of all diabetes patients, especially those who are walking a lot while having insensate or at-risk feet. Very often it is tempting to believe that those patients who are walking long distances and who are quite fit will not develop diabetic foot complications. For these patients who are very fit and able to walk long distances, foot self-examination can be preferred. Because there is an element of a temperature sensation that is required in foot examination, infrared thermal cameras have been used for self imaging by patients to identify areas of warmth in the foot.

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