By Michael E. Edmonds, Alethea VM Foster
Written via the BMA award-winning writer workforce of Mike Edmonds and Alethea FosterAimed at podiatrists, nurses, physicians, surgeons, orthotists and all different contributors of the multidisciplinary diabetic foot crew, handling the Diabetic Foot, moment version, continues to be a “must-have” for all these drawn to diabetes and the diabetic foot.New gains of this moment version contain: bankruptcy on amputation has been multiplied as has the final surgical concentration Metabolic keep an eye on and all different facets of administration have additionally been broadly up to date New introductory bankruptcy which describes the review of the diabetic foot, incorporating an illustrated part on differential prognosis content material aids the implementation of the good guidance and the ‘National carrier Framework for Diabetes’
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Extra info for Managing the Diabetic Foot
NAILS Cut nails after a bath or shower when they are softer Do not try to cut the whole nail in one piece Do not cut nails too short or leave them poking beyond the end of the toe Never cut out the corner of the nail or dig down the sides If nails are painful or difficult to cut, then see a stateregistered podiatrist. In the UK, treatment is available on the National Health Service. DAILYFOOT CHECK Check feet for danger signs of swelling, colour change, pain or breaks in the skin and seek immediate help if these occur Seek advice for minor wounds which do not heal.
The apex of the second toe on the contralateral foot shows neglected callus. Fig. 2 (a) Callus over the forefoot has been left too long as it was not painful. (b) Debridement by the podiatrist reveals tissue breakdown -the birth of a neuropathic ulcer. 54 Stage 3: The ulcerated foot may often reveal ulcers (Figs. 3a and b). Ulcers on the plantar aspect of the heel are usually caused by acute trauma, in particular, treading on foreign bodies. On initial observation, a neuropathic ulcer may seem shallow.
SUBUNGUAL HAEMATOMA TINEAPEDIS This can present in several ways: moist, cracked areas with whitish macerated skin between the toes, a dry, scaly hyperkeratotic area or a vesicular itchy rash (Fig. 10) are all presentations. Canesten spray (clotrimazole 1% in 30% isopropyl alcohol) or cream may be prescribed, which should be continued for 2 weeks after resolution of symptoms to avoid relapse. For other parts of the foot, Canesten cream can be applied. Whitfield's ointment is useful. Tinactin (tolnaftate) and Mycil (chlorphenesin) can be bought over the counter in powder or cream formulations.
Managing the Diabetic Foot by Michael E. Edmonds, Alethea VM Foster