It provides information regarding diabetic foot and it's management and prevention.

1. FOOT PROBLEM
Prepared By:
Sonali Koiri
Sujata Katuwal

2. Objective
At the end of the session the participant will be
able to :
recall foot problem.
explain management of foot problem.

5. Foot problem
Foot ulceration occurs as a result of trauma in
the presence of neuropathy and /or peripheral
vascular disease, with infection occuring as a
secondary phenomenon following disruption
of the protective epidermis.

6. Clinical features of diabetic foot
Neuropathy Ischemia
Symptoms None
Paraesthesiae
Pain
Numbness
None
Claudication
Rest pain
Structured damage Ulcer
Sepsis
Abscess
Osteomyelitis
Digital gangrene
Charcot joint
Ulcer
Sepsis
Gangrene

8. Management of diabetic foot ulcer
Treatment
• Remove callus.
• Treat infection.
• Avoid weight-bearing.
• Ensure good glycaemic control.
• Control edema.
• Undertake angiogram to assess feasibility of
vascular reconstruction where indicated.

9. Prevention
• Prevention is the most effective way of dealing
with the problem of tissue necrosis in the
diabetic foot.
• Advice to all diabetic patients includes:
 Inspect feet everyday.
 Wash feet everyday.
 Moisture skin if dry.
 Cut or file toenails regularly.
 Change socks or stocking everyday.
 Avoid walking barefoot.

10. Contd
 Check footwear for foreign bodies.
 Wear suitable good-fitting shoes.
 Cover minor cuts with sterile dressing.
 Do nut brust blisters.
 Avoid over –the –counter corn/ callus remedies.
 Avoid high and low temperature.
 Specially manufacture and fitted orthotic footwear
is required to prevent recurrence of ulceration and
protect the feet of patients with Charcot
neuropathy.

11. Reference
1. Colledge NR, Walker BR, Ralston SH.
Davidson’s Principles & Practice of Medicine.
21st ed:2010. 833-834.