Diabetic feet Flashcards
causes behind foot ulceration?
Sensory neuropathy Motor neuropathy Limited joint mobility Autonomic neuropathy Peripheral vascular disease Trauma - repeated minor/discrete episode Reduced resistance to infection Other diabetic complications eg. retinopathy
describe the neuropathic foot and where ulcers are most common
numb, warm, dry, palpable foot pulses, ulcers at points of high pressure loading.
describe the ischaemic foot and where ulcers are most common
cold, pulseless, ulcers at the foot margins.
describe the neuro-ischaemia foot and where ulcers are most common
numb, cold, dry, pulseless, ulcers at points of high pressure loading and at foot margins.
on what basis would you assess the foot of a diabetic patient?
Appearance - ? Deformity ? Callus Feel - ? Hot/cold ? Dry Foot pulses dorsalis pedis / posterior tibial pulse Neuropathy vibration sensation, temperature, ankle jerk reflex, fine touch sensation
management from diabetes perspective- what to control?
Hyperglycaemia Hypertension Dyslipidaemia Stop smoking Education
prevention management for a diabetic foot
Control diabetes inspect feet daily have feet measured when buying shoes buy shoes with laces and square toe box inspect inside of shoes for foreign objectsattend chiropodist cut nails straight across care with heat never walk barefoot
management of a foot ulceration
Relief of pressure
bed rest (risk of DVT, heel ulceration)
redistribution of pressure/total contact cast
Antibiotics, possibly long term
Debridement
Revascularization
angioplasty
arterial bypass surgery
Amputation
