Talk amongst yourselves!• What do you want to know?
Back ground• “Public foot the bill, patients pay the price”• National figures• 15% will develop ulcer in their life• 2% PA develop new ulcer• Of those with neuropathy, 3% will develop an ulcer each year• Incidence of major amputation 3% per year• 5 year mortality for patients presenting with new foot disease is 45-50%
World Health Organisationdefinition of the Diabetic Foot “a group of syndromes in which neuropathy, ischaemia, and infection lead to tissue breakdown resulting in morbidity and possible amputation”
Plymouth PCT Population• In 2008/09 there were 10321 people aged 17 years and older diagnosed with diabetes in Plymouth PCT. (3.8% compared with 4.0% of population in a range of similar PCTs)
Guidance• NICE cg 10• NICE cg 119, inpatient management of diabetic Foot• Map of medicine (Diabetes/Foot care)• Local guidance ;Inpatient pathway,• joint formulary,
What are the main problemsaffecting the lower limbs of people• Infection• Neuropathy• Arterial disease• Foot deformity• MOBILITY
Classification of wounds• European Pressure Ulcer Advisory Panel (EPUAP) system 1 to 4 grading
Prevention is the key• Observation• Pressure relief• Footwear• Appropriate and fast referral