People suffering from diabetes are at risk of developing foot problem. There is an estimation of one out of 10 struggling with foot ulcer because of this condition, at least once in their lifetime. Diabetes is also a common cause for limb amputation, which is not related to any traumatic condition but 80% amputations are predicted to be due to foot ulceration [according to NICE 2016].
In Birmingham, foot ulcers have adversely affected people’s life quality. NICE has highlighted prevention and management of diabetic foot problems. Five key elements to prevent diabetic foot problems in Birmingham are identified.
- Identifying at-risk foot
- Education of patient, healthcare providers and family
- Regular inspection & examination of at-risk foot
- Pre-ulcerative sign treatment
- Wear appropriate routine footwear
At-risk patient is described as ‘patient with diabetes suffering from peripheral neuropathy with peripheral artery disease, or with or without foot deformity, or amputation of leg/foot [a part], or foot ulcer/s history’. It is recommended that every diabetic patient needs to have their foot examined once every year and those with risk factor need to go for check-up on the basis of their risk category.
Practically, patient education to prevent foot ulcer is not sufficient but incorporating healthcare providers and family will help to enhance their knowledge and skills. Moreover, offer motivation to sustain foot care, which is an incorporated approach towards preventive care.
Treatment for diabetes foot ulcers
Evaluating foot wound includes assessment of cause, type, depth, and infection site. Treatment of foot ulcer is supported by key elements including
- Pressure relief and ulcer protection
- Restoring skin perfusion
- Infection treatment
- Local wound care
- Metabolic control & co-morbidity treatment
- Patient & relative teaching
- Prevention of recurrence
Holistic treatment approach is regarded as good practise.