SlideShare a Scribd company logo
THE ROLE OF THE
PODIATRIST IN THE CARE
OF THE DIABETIC FOOT
By Zoe Boulton
Contents








Assessment of the diabetic foot
Features of ulcerations
Debridement
Dressings
Biomechanics
Offloading
General Role of the Podiatrist








Identification of patients who are at risk of
developing foot problems
Establish a risk score for patient as per NICE
guidelines (Low, Moderate, High)
Providing appropriate treatment/ assessment
Education to patients and other professionals
Work as part of larger multidisciplinary team
Vascular assessment


Palpate pulses or use Doppler

Dorsalis Pedis

Posterior Tibialis
ABPI







Can be useful in determining level of
ischaemia
Carried out when ischaemia is suspected
Values of: <0.8: the foot is at risk of ulceration
<0.5: the foot is critically ischaemic
Caution: May give false readings in diabetic
patients due to calcification of arteries
consider pallor on elevation and dependant
rubor also.
Neurological Assessment



Monofilament
8/10 or below neuropathy
Neurothesiometer

Above 25 volts indicates
presence of peripheral
neuropathy
Typical features of Ulceration
Neuropathic

Ischaemic

Pulses

Bounding

Diminished/absent

Pain

None/minimal

High degree of pain

Location of
Ulceration

Pressure areas

Borders of feet

Callus

Often large amounts

Minimal
Assessment of Diabetic Foot








Presence of Infection (bacteria and fungi)
Ulceration/ foreign bodies
Pre-ulcerative areas
Deformity
Oedema
Skin quality
Footwear
Debridement






Sharp debridement
Allows true extent of ulcer to be revealed
Allows healing with removal of slough and
dead tissue
Maggots
Case Study


Patient presented after walking on a gripper
rod.
This was also discovered …
Wound Bed
Granulating

Sloughly
Dressings








Wound bed
Consider patient
Exudate management
Moist healing environment
Negative Pressure dressings
Not the be all and end all !!
Biomechanics of foot





Altered foot function can be a cause of
ulceration eg hallux limitus.
Forefoot equinus
Glycosylation of tissues and amount of
deformity in foot can indicate severity of
neuropathy
Offloading





Felt
Bespoke insoles and footwear- rocker soles
PRAFO
Aircast
Conclusion






Podiatrists work as part of a multidisciplinary
team when managing the diabetic foot
The diabetic foot MUST be managed as part of
a wide team involving a number of specialities.
We all aim to facilitate healing and ensure the
best care for the patient

Thanks for listening 

More Related Content

What's hot

Diabetic foot
Diabetic footDiabetic foot
Diabetic foot
joemdas
 
Fragility fractures
Fragility fracturesFragility fractures
Fragility fractures
NamithRangaswamy
 
Plantar fascitis final
Plantar fascitis finalPlantar fascitis final
Plantar fascitis finalAnkur Mittal
 
Hip Osteoarthrosis -PAWAN
Hip Osteoarthrosis -PAWANHip Osteoarthrosis -PAWAN
Hip Osteoarthrosis -PAWAN
Pawan Yadav
 
Common sports injuries.2560
Common sports injuries.2560Common sports injuries.2560
Common sports injuries.2560
Ukris Ortho
 
chondromalacia patellae
chondromalacia patellae chondromalacia patellae
chondromalacia patellae orthoprince
 
Management of diabetic foot
Management of diabetic footManagement of diabetic foot
Management of diabetic foot
Rahulkumar5300
 
Osteoarthritis
Osteoarthritis Osteoarthritis
Osteoarthritis
Abdulrahman Alarfaj
 
Foot pathology(metatarsalgia)
Foot pathology(metatarsalgia)Foot pathology(metatarsalgia)
Foot pathology(metatarsalgia)
Md. Nayeem Hasan
 
Surgical approaches in orthopaedics- General principles
Surgical approaches in orthopaedics- General principlesSurgical approaches in orthopaedics- General principles
Surgical approaches in orthopaedics- General principles
Dr.A.Mohan krishna
 
Examination evaluation & Assessment of Ankle & Foot
Examination evaluation & Assessment of Ankle & Foot Examination evaluation & Assessment of Ankle & Foot
Examination evaluation & Assessment of Ankle & Foot
Lady Reading Hospital-Medical Teaching Institution, Peshawar
 
The diabetic foot; state of the art
The diabetic foot; state of the artThe diabetic foot; state of the art
The diabetic foot; state of the art
MEEQAT HOSPITAL
 
Avascular Necrosis of the Hip
Avascular Necrosis of the HipAvascular Necrosis of the Hip
Avascular Necrosis of the Hip
David S. Feldman, MD
 
Chondromalacia patella
Chondromalacia patellaChondromalacia patella
Chondromalacia patella
nedaentezari
 
OSTEOARTRITIS OF KNEE (OA).pptx
OSTEOARTRITIS OF KNEE (OA).pptxOSTEOARTRITIS OF KNEE (OA).pptx
OSTEOARTRITIS OF KNEE (OA).pptx
snehalkale43
 
Spinal canal stenosis
Spinal canal stenosisSpinal canal stenosis
Spinal canal stenosis
Md Ashiqur Rahman
 
Hallux Varus
Hallux Varus Hallux Varus
Hallux Varus
drbernhard
 
Peri arthritis shoulder/ frozen shoulder
Peri arthritis shoulder/ frozen shoulder Peri arthritis shoulder/ frozen shoulder
Peri arthritis shoulder/ frozen shoulder
Career Point University
 
Diabetic Foot
Diabetic FootDiabetic Foot
Diabetic Foot
Ahmed Moamen
 

What's hot (20)

Diabetic foot
Diabetic footDiabetic foot
Diabetic foot
 
Fragility fractures
Fragility fracturesFragility fractures
Fragility fractures
 
Plantar fascitis final
Plantar fascitis finalPlantar fascitis final
Plantar fascitis final
 
Hip Osteoarthrosis -PAWAN
Hip Osteoarthrosis -PAWANHip Osteoarthrosis -PAWAN
Hip Osteoarthrosis -PAWAN
 
Common sports injuries.2560
Common sports injuries.2560Common sports injuries.2560
Common sports injuries.2560
 
Osteoarthritis
OsteoarthritisOsteoarthritis
Osteoarthritis
 
chondromalacia patellae
chondromalacia patellae chondromalacia patellae
chondromalacia patellae
 
Management of diabetic foot
Management of diabetic footManagement of diabetic foot
Management of diabetic foot
 
Osteoarthritis
Osteoarthritis Osteoarthritis
Osteoarthritis
 
Foot pathology(metatarsalgia)
Foot pathology(metatarsalgia)Foot pathology(metatarsalgia)
Foot pathology(metatarsalgia)
 
Surgical approaches in orthopaedics- General principles
Surgical approaches in orthopaedics- General principlesSurgical approaches in orthopaedics- General principles
Surgical approaches in orthopaedics- General principles
 
Examination evaluation & Assessment of Ankle & Foot
Examination evaluation & Assessment of Ankle & Foot Examination evaluation & Assessment of Ankle & Foot
Examination evaluation & Assessment of Ankle & Foot
 
The diabetic foot; state of the art
The diabetic foot; state of the artThe diabetic foot; state of the art
The diabetic foot; state of the art
 
Avascular Necrosis of the Hip
Avascular Necrosis of the HipAvascular Necrosis of the Hip
Avascular Necrosis of the Hip
 
Chondromalacia patella
Chondromalacia patellaChondromalacia patella
Chondromalacia patella
 
OSTEOARTRITIS OF KNEE (OA).pptx
OSTEOARTRITIS OF KNEE (OA).pptxOSTEOARTRITIS OF KNEE (OA).pptx
OSTEOARTRITIS OF KNEE (OA).pptx
 
Spinal canal stenosis
Spinal canal stenosisSpinal canal stenosis
Spinal canal stenosis
 
Hallux Varus
Hallux Varus Hallux Varus
Hallux Varus
 
Peri arthritis shoulder/ frozen shoulder
Peri arthritis shoulder/ frozen shoulder Peri arthritis shoulder/ frozen shoulder
Peri arthritis shoulder/ frozen shoulder
 
Diabetic Foot
Diabetic FootDiabetic Foot
Diabetic Foot
 

Viewers also liked

Hypogonadism and testosterone replacement part 2
Hypogonadism and testosterone replacement part 2Hypogonadism and testosterone replacement part 2
Hypogonadism and testosterone replacement part 2PeninsulaEndocrine
 
About Dr. Marc Blatstein
About Dr. Marc BlatsteinAbout Dr. Marc Blatstein
About Dr. Marc Blatstein
Dr Marc Blatstein
 
Mdsc 1102 pbl 3
Mdsc 1102 pbl 3Mdsc 1102 pbl 3
Mdsc 1102 pbl 3
Arvind Seecharan
 
Foot corns, calluses & blister treatment
Foot corns, calluses & blister treatmentFoot corns, calluses & blister treatment
Foot corns, calluses & blister treatment
CATHY WILLIAMS
 
Podiatry: What you were always too afraid to ask
Podiatry: What you were always too afraid to askPodiatry: What you were always too afraid to ask
Podiatry: What you were always too afraid to ask
Cameron Kippen
 
Agnesian HealthCare Know & Go Friday, March 2017: Podiatry & Health Shoppe
Agnesian HealthCare Know & Go Friday, March 2017: Podiatry & Health ShoppeAgnesian HealthCare Know & Go Friday, March 2017: Podiatry & Health Shoppe
Agnesian HealthCare Know & Go Friday, March 2017: Podiatry & Health Shoppe
Agnesian HealthCare
 
Podiatry & Foot Care - General Tips (Northern Foot Care)
Podiatry & Foot Care - General Tips (Northern Foot Care)Podiatry & Foot Care - General Tips (Northern Foot Care)
Podiatry & Foot Care - General Tips (Northern Foot Care)
Dr. Daniel Reminga
 
Hypogonadism and testosterone replacement
Hypogonadism and testosterone replacementHypogonadism and testosterone replacement
Hypogonadism and testosterone replacementPeninsulaEndocrine
 
Erectile dysfunction in diabetes
Erectile dysfunction in diabetesErectile dysfunction in diabetes
Erectile dysfunction in diabetesPeninsulaEndocrine
 

Viewers also liked (12)

Hypogonadism and testosterone replacement part 2
Hypogonadism and testosterone replacement part 2Hypogonadism and testosterone replacement part 2
Hypogonadism and testosterone replacement part 2
 
Podiatry: Searching for Evidence
Podiatry: Searching for EvidencePodiatry: Searching for Evidence
Podiatry: Searching for Evidence
 
About Dr. Marc Blatstein
About Dr. Marc BlatsteinAbout Dr. Marc Blatstein
About Dr. Marc Blatstein
 
Kallmann syndrome
Kallmann syndromeKallmann syndrome
Kallmann syndrome
 
Mdsc 1102 pbl 3
Mdsc 1102 pbl 3Mdsc 1102 pbl 3
Mdsc 1102 pbl 3
 
Foot corns, calluses & blister treatment
Foot corns, calluses & blister treatmentFoot corns, calluses & blister treatment
Foot corns, calluses & blister treatment
 
Podiatry: What you were always too afraid to ask
Podiatry: What you were always too afraid to askPodiatry: What you were always too afraid to ask
Podiatry: What you were always too afraid to ask
 
Agnesian HealthCare Know & Go Friday, March 2017: Podiatry & Health Shoppe
Agnesian HealthCare Know & Go Friday, March 2017: Podiatry & Health ShoppeAgnesian HealthCare Know & Go Friday, March 2017: Podiatry & Health Shoppe
Agnesian HealthCare Know & Go Friday, March 2017: Podiatry & Health Shoppe
 
Podiatry & Foot Care - General Tips (Northern Foot Care)
Podiatry & Foot Care - General Tips (Northern Foot Care)Podiatry & Foot Care - General Tips (Northern Foot Care)
Podiatry & Foot Care - General Tips (Northern Foot Care)
 
Hypogonadism and testosterone replacement
Hypogonadism and testosterone replacementHypogonadism and testosterone replacement
Hypogonadism and testosterone replacement
 
Erectile dysfunction in diabetes
Erectile dysfunction in diabetesErectile dysfunction in diabetes
Erectile dysfunction in diabetes
 
The diabetic foot
The diabetic footThe diabetic foot
The diabetic foot
 

Similar to The role of the podiatrist

Ankle brachial index
Ankle brachial indexAnkle brachial index
Ankle brachial index
DrShwetaPanchbudhe
 
Diagnostic guidelines for peripheral arterial disease
Diagnostic guidelines for peripheral arterial diseaseDiagnostic guidelines for peripheral arterial disease
Diagnostic guidelines for peripheral arterial disease
Perimed
 
Diagnostic guidelines for peripheral arterial disease web
Diagnostic guidelines for peripheral arterial disease webDiagnostic guidelines for peripheral arterial disease web
Diagnostic guidelines for peripheral arterial disease web
Perimed
 
N325 peripheral vascular student version
N325 peripheral vascular student versionN325 peripheral vascular student version
N325 peripheral vascular student version
Alex Murray
 
Diagnosing peripheral arterial disease and assessing degree of ischemia
Diagnosing peripheral arterial disease and assessing degree of ischemia Diagnosing peripheral arterial disease and assessing degree of ischemia
Diagnosing peripheral arterial disease and assessing degree of ischemia
Perimed
 
Peripheral artery disease
Peripheral artery diseasePeripheral artery disease
Peripheral artery disease
mahboobehsheikh
 
6571552380502.ppt
6571552380502.ppt6571552380502.ppt
6571552380502.ppt
SouparnaMandal1
 
PAD & Lower Extremity Interventions
PAD & Lower Extremity InterventionsPAD & Lower Extremity Interventions
PAD & Lower Extremity Interventions
NAJEEB ULLAH SOFI
 
Assessment of ankle_brachial_pressure_index_in_drivers
Assessment of ankle_brachial_pressure_index_in_driversAssessment of ankle_brachial_pressure_index_in_drivers
Assessment of ankle_brachial_pressure_index_in_drivers
Usha Sri
 
Diabetic Foot Clinic
Diabetic Foot ClinicDiabetic Foot Clinic
Diabetic Foot Clinic
sasik81
 
ABC's of MEDICAL and SURGICAL NURSING
ABC's of MEDICAL and SURGICAL NURSINGABC's of MEDICAL and SURGICAL NURSING
ABC's of MEDICAL and SURGICAL NURSING
Sam Malenab
 
IWGDF-2023-05-PAD-Guideline.pdf
IWGDF-2023-05-PAD-Guideline.pdfIWGDF-2023-05-PAD-Guideline.pdf
IWGDF-2023-05-PAD-Guideline.pdf
ssuser844039
 
Operations_Manual_Physical_Exam.pdf
Operations_Manual_Physical_Exam.pdfOperations_Manual_Physical_Exam.pdf
Operations_Manual_Physical_Exam.pdf
HebaSalem41
 
PERIPHERAL ARTERY DISEASE.pptx
PERIPHERAL ARTERY DISEASE.pptxPERIPHERAL ARTERY DISEASE.pptx
PERIPHERAL ARTERY DISEASE.pptx
sandeep754264
 
Tingling in legs Causes and Treatment
Tingling in legs Causes and TreatmentTingling in legs Causes and Treatment
Tingling in legs Causes and Treatment
USA Vascular Centers
 
Peripheral artery disease
Peripheral artery diseasePeripheral artery disease
Peripheral artery disease
Dr Dinesh Pandey
 
guideline periperal arterial disease in adult
guideline periperal arterial disease in adultguideline periperal arterial disease in adult
guideline periperal arterial disease in adult
JansenB1
 
Ankle brachial pressure index (ABPI)
Ankle brachial pressure index (ABPI)Ankle brachial pressure index (ABPI)
Ankle brachial pressure index (ABPI)
Jibran Mohsin
 
Determining a vascular cause for leg pain and referrals
Determining a vascular cause for leg pain and referralsDetermining a vascular cause for leg pain and referrals
Determining a vascular cause for leg pain and referrals
SpecialistVeinHealth
 

Similar to The role of the podiatrist (20)

Ankle brachial index
Ankle brachial indexAnkle brachial index
Ankle brachial index
 
Diagnostic guidelines for peripheral arterial disease
Diagnostic guidelines for peripheral arterial diseaseDiagnostic guidelines for peripheral arterial disease
Diagnostic guidelines for peripheral arterial disease
 
Diagnostic guidelines for peripheral arterial disease web
Diagnostic guidelines for peripheral arterial disease webDiagnostic guidelines for peripheral arterial disease web
Diagnostic guidelines for peripheral arterial disease web
 
N325 peripheral vascular student version
N325 peripheral vascular student versionN325 peripheral vascular student version
N325 peripheral vascular student version
 
Diagnosing peripheral arterial disease and assessing degree of ischemia
Diagnosing peripheral arterial disease and assessing degree of ischemia Diagnosing peripheral arterial disease and assessing degree of ischemia
Diagnosing peripheral arterial disease and assessing degree of ischemia
 
Peripheral artery disease
Peripheral artery diseasePeripheral artery disease
Peripheral artery disease
 
6571552380502.ppt
6571552380502.ppt6571552380502.ppt
6571552380502.ppt
 
PAD & Lower Extremity Interventions
PAD & Lower Extremity InterventionsPAD & Lower Extremity Interventions
PAD & Lower Extremity Interventions
 
Assessment of ankle_brachial_pressure_index_in_drivers
Assessment of ankle_brachial_pressure_index_in_driversAssessment of ankle_brachial_pressure_index_in_drivers
Assessment of ankle_brachial_pressure_index_in_drivers
 
Diabetic Foot Clinic
Diabetic Foot ClinicDiabetic Foot Clinic
Diabetic Foot Clinic
 
ABC's of MEDICAL and SURGICAL NURSING
ABC's of MEDICAL and SURGICAL NURSINGABC's of MEDICAL and SURGICAL NURSING
ABC's of MEDICAL and SURGICAL NURSING
 
IWGDF-2023-05-PAD-Guideline.pdf
IWGDF-2023-05-PAD-Guideline.pdfIWGDF-2023-05-PAD-Guideline.pdf
IWGDF-2023-05-PAD-Guideline.pdf
 
Operations_Manual_Physical_Exam.pdf
Operations_Manual_Physical_Exam.pdfOperations_Manual_Physical_Exam.pdf
Operations_Manual_Physical_Exam.pdf
 
Lecture 29 shah diabetic fractures copy
Lecture 29 shah diabetic fractures   copyLecture 29 shah diabetic fractures   copy
Lecture 29 shah diabetic fractures copy
 
PERIPHERAL ARTERY DISEASE.pptx
PERIPHERAL ARTERY DISEASE.pptxPERIPHERAL ARTERY DISEASE.pptx
PERIPHERAL ARTERY DISEASE.pptx
 
Tingling in legs Causes and Treatment
Tingling in legs Causes and TreatmentTingling in legs Causes and Treatment
Tingling in legs Causes and Treatment
 
Peripheral artery disease
Peripheral artery diseasePeripheral artery disease
Peripheral artery disease
 
guideline periperal arterial disease in adult
guideline periperal arterial disease in adultguideline periperal arterial disease in adult
guideline periperal arterial disease in adult
 
Ankle brachial pressure index (ABPI)
Ankle brachial pressure index (ABPI)Ankle brachial pressure index (ABPI)
Ankle brachial pressure index (ABPI)
 
Determining a vascular cause for leg pain and referrals
Determining a vascular cause for leg pain and referralsDetermining a vascular cause for leg pain and referrals
Determining a vascular cause for leg pain and referrals
 

More from PeninsulaEndocrine

Gestational diabetes
Gestational diabetesGestational diabetes
Gestational diabetes
PeninsulaEndocrine
 
Endocrine disease in pregnancy
Endocrine disease in pregnancyEndocrine disease in pregnancy
Endocrine disease in pregnancy
PeninsulaEndocrine
 
Diabetes in pregnancy
Diabetes in pregnancyDiabetes in pregnancy
Diabetes in pregnancy
PeninsulaEndocrine
 
Hypoglycaemia in older people
Hypoglycaemia in older peopleHypoglycaemia in older people
Hypoglycaemia in older people
PeninsulaEndocrine
 
Diabetes in the elderly
Diabetes in the elderlyDiabetes in the elderly
Diabetes in the elderly
PeninsulaEndocrine
 
Primary hyperaldosteronism - arterial venous sampling cases
Primary hyperaldosteronism - arterial venous sampling casesPrimary hyperaldosteronism - arterial venous sampling cases
Primary hyperaldosteronism - arterial venous sampling cases
PeninsulaEndocrine
 
ADVANCE - Type 2 diabetes - vascular risk with intervention
ADVANCE - Type 2 diabetes - vascular risk with interventionADVANCE - Type 2 diabetes - vascular risk with intervention
ADVANCE - Type 2 diabetes - vascular risk with interventionPeninsulaEndocrine
 
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with intervention
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with interventionDCCT/EDIC - Type 1 diabetes - cardiovascular risk with intervention
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with interventionPeninsulaEndocrine
 
DCCT – intensive diabetes therapy and glomerular filtration
DCCT – intensive diabetes therapy and glomerular filtrationDCCT – intensive diabetes therapy and glomerular filtration
DCCT – intensive diabetes therapy and glomerular filtrationPeninsulaEndocrine
 
Macrovascular disease in diabetes
Macrovascular disease in diabetesMacrovascular disease in diabetes
Macrovascular disease in diabetesPeninsulaEndocrine
 

More from PeninsulaEndocrine (20)

Gestational diabetes
Gestational diabetesGestational diabetes
Gestational diabetes
 
Endocrine disease in pregnancy
Endocrine disease in pregnancyEndocrine disease in pregnancy
Endocrine disease in pregnancy
 
Diabetes in pregnancy
Diabetes in pregnancyDiabetes in pregnancy
Diabetes in pregnancy
 
Hypoglycaemia in older people
Hypoglycaemia in older peopleHypoglycaemia in older people
Hypoglycaemia in older people
 
Diabetes in the elderly
Diabetes in the elderlyDiabetes in the elderly
Diabetes in the elderly
 
Primary hyperaldosteronism - arterial venous sampling cases
Primary hyperaldosteronism - arterial venous sampling casesPrimary hyperaldosteronism - arterial venous sampling cases
Primary hyperaldosteronism - arterial venous sampling cases
 
Calcium metabolism handout
Calcium metabolism handoutCalcium metabolism handout
Calcium metabolism handout
 
Calcium metabolism handout
Calcium metabolism handoutCalcium metabolism handout
Calcium metabolism handout
 
Kallmann syndrome
Kallmann syndromeKallmann syndrome
Kallmann syndrome
 
ADVANCE - Type 2 diabetes - vascular risk with intervention
ADVANCE - Type 2 diabetes - vascular risk with interventionADVANCE - Type 2 diabetes - vascular risk with intervention
ADVANCE - Type 2 diabetes - vascular risk with intervention
 
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with intervention
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with interventionDCCT/EDIC - Type 1 diabetes - cardiovascular risk with intervention
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with intervention
 
DCCT - Hypoglycemia
DCCT - HypoglycemiaDCCT - Hypoglycemia
DCCT - Hypoglycemia
 
DCCT overview
DCCT overviewDCCT overview
DCCT overview
 
DCCT – intensive diabetes therapy and glomerular filtration
DCCT – intensive diabetes therapy and glomerular filtrationDCCT – intensive diabetes therapy and glomerular filtration
DCCT – intensive diabetes therapy and glomerular filtration
 
UKPDS overview
UKPDS overviewUKPDS overview
UKPDS overview
 
UKPDS - 10 year follow up
UKPDS - 10 year follow upUKPDS - 10 year follow up
UKPDS - 10 year follow up
 
Pituitary disease
Pituitary diseasePituitary disease
Pituitary disease
 
Adrenocortical tumours
Adrenocortical tumoursAdrenocortical tumours
Adrenocortical tumours
 
Adrenal Incidentalomas
Adrenal IncidentalomasAdrenal Incidentalomas
Adrenal Incidentalomas
 
Macrovascular disease in diabetes
Macrovascular disease in diabetesMacrovascular disease in diabetes
Macrovascular disease in diabetes
 

Recently uploaded

POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
touseefaziz1
 
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
i3 Health
 
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
GL Anaacs
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
aljamhori teaching hospital
 
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptxTriangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
24 Upakrama.pptx class ppt useful in all
24 Upakrama.pptx class ppt useful in all24 Upakrama.pptx class ppt useful in all
24 Upakrama.pptx class ppt useful in all
DrSathishMS1
 
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdfBENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
DR SETH JOTHAM
 
BRACHYTHERAPY OVERVIEW AND APPLICATORS
BRACHYTHERAPY OVERVIEW  AND  APPLICATORSBRACHYTHERAPY OVERVIEW  AND  APPLICATORS
BRACHYTHERAPY OVERVIEW AND APPLICATORS
Krishan Murari
 
The Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of IIThe Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of II
MedicoseAcademics
 
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #GirlsFor Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
Savita Shen $i11
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
د.محمود نجيب
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
MedicoseAcademics
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
NephroTube - Dr.Gawad
 
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 UpakalpaniyaadhyayaCharaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Dr KHALID B.M
 
Antiulcer drugs Advance Pharmacology .pptx
Antiulcer drugs Advance Pharmacology .pptxAntiulcer drugs Advance Pharmacology .pptx
Antiulcer drugs Advance Pharmacology .pptx
Rohit chaurpagar
 
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model SafeSurat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Savita Shen $i11
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
addon Scans
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
greendigital
 
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
Swetaba Besh
 
Ophthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE examOphthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE exam
KafrELShiekh University
 

Recently uploaded (20)

POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
 
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
 
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
 
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptxTriangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
 
24 Upakrama.pptx class ppt useful in all
24 Upakrama.pptx class ppt useful in all24 Upakrama.pptx class ppt useful in all
24 Upakrama.pptx class ppt useful in all
 
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdfBENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
 
BRACHYTHERAPY OVERVIEW AND APPLICATORS
BRACHYTHERAPY OVERVIEW  AND  APPLICATORSBRACHYTHERAPY OVERVIEW  AND  APPLICATORS
BRACHYTHERAPY OVERVIEW AND APPLICATORS
 
The Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of IIThe Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of II
 
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #GirlsFor Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
 
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 UpakalpaniyaadhyayaCharaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
 
Antiulcer drugs Advance Pharmacology .pptx
Antiulcer drugs Advance Pharmacology .pptxAntiulcer drugs Advance Pharmacology .pptx
Antiulcer drugs Advance Pharmacology .pptx
 
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model SafeSurat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
 
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
 
Ophthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE examOphthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE exam
 

The role of the podiatrist

Editor's Notes

  1. When considering any aspect of a diabetic foot it is vital that there is a MDT approach podiatrists need glucose levels to be optimum to encourage healing but also need footwear to be bespoke in man cases. Also need community staff both pods and nurses for redressing etc.
  2. If palpable then fair to say not too bad but use as part of clinical pic as neuro feet often bounding pulses. These are two main pulses checked can also use peroneal as another indicator.
  3. Monofilament detects dysfunction of small fibres this is pain and temp through the alpha delta nerve fibres and c fibres is repeatable and exerts 10g of pressure each time must be allowed to buckle and should be held there for 1 sec. Get patient to close eyes as many will want to please practitioner !!!
  4. Neurothesiometer: rested on apex of digit (usually 1st) detects LARGE fibre neuropathy .........
  5. Table indicating the difference in types of ulceration (MOLLIE MAY HAVE INCLUDED THIS )
  6. The presence of tidea pedis infection aka (althetes foot) needs to be addressed in a diabetic as can lead to secondary bacteria infections. Found interdigital with red skin, odour, peeling skin ?itch (neuro) toes tend to be fixed/ close together – topical treatment Obvious one and check shoesAreas such as in picture one can indicate that that area is receiving high amounts of pressure and tissue exhibit extravasation which if left would lead to ulceration requires debriding and offloading. However this could also be an ulceration under callus. Deformity eg charcot but also toe deformity such as claw/ hammer and mallet as this increases pressure to areas like wise HAV etc. Indicator of systemic conditions but also consideration for footwear as wont be able to wear off the shelf.Is it dry? Fissured? Indicatiors of neuropathy and patient care for foot health, also too much tape thin skin in elderly etc. Need referral to orthotist ?
  7. Allows healing and drainage of wound Removal of non- viable tissueCallus will often build up over wounds and form a plug essentially. Maggots are an alternative in presence of adherent slough but use cautiously due to cost
  8. Dressing evidence is very poor quality. Often our dressing choice is determined on the observation of the wound bed and then dressed accordingly. Granulating wounds may simply require protection where as sloughly wounds will require dressings that encourage removal of slough and allow hyealing of the wound. Necrosis – keep dry. Important to consider patient high exduate levels, if working ?Important to manage exudate to prevent excouriation.