High Risk Diabetic Foot

2010 ◽  
Keyword(s):  
High Risk ◽  
Diabetic Foot

Surgical Off-loading of the Diabetic Foot

2010 ◽  
Vol 100 (5) ◽  
pp. 369-384 ◽  
Author(s):  
Robert G. Frykberg ◽  
Nicholas J. Bevilacqua ◽  
Geoffrey Habershaw
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Diabetic Foot ◽  
Surgical Intervention ◽  
Surgical Decompression ◽  
Foot Ulcers ◽  
Foot Surgery ◽  
Patients With Diabetes

Surgical intervention for chronic deformities and ulcerations has become an important component in the management of patients with diabetes mellitus. Such patients are no longer relegated to wearing cumbersome braces or footwear for deformities that might otherwise be easily corrected. Although surgical intervention in these often high-risk individuals is not without risk, the outcomes are fairly predictable when patients are properly selected and evaluated. In this brief review, we discuss the rationale and indications for diabetic foot surgery, focusing on the surgical decompression of deformities that frequently lead to foot ulcers. (J Am Podiatr Med Assoc 100(5): 369–384, 2010)

scholarly journals Pedographic assessment of the impact of off-the-shelf orthopedic shoes on the load distribution under the feet in patients with a high risk of developing diabetic foot syndrome

2021 ◽  
Vol 23 (5) ◽  
pp. 442-451
Author(s):  
Vadim B. Bregovskiy ◽  
Oleg V. Udovichenko ◽  
Anastasia G. Demina ◽  
Eugenia Aleksandrovna Berseneva ◽  
Irina A. Karpova
Keyword(s):  
High Risk ◽  
Diabetic Foot ◽  
Load Distribution ◽  
Objective Assessment ◽  
Daily Basis ◽  
Diabetic Foot Syndrome ◽  
Lateral Part ◽  
Plantar Surface ◽  
The Impact ◽  
Orthopedic Shoes

BACKGROUND: It is known that the so-called “rocker” outsole helps to reduce the load on the forefoot and toes. Such an outsole is available in ready-made orthopedic shoes of some Russian manufacturers, however, an objective assessment of their impact on the load distribution under the foot during walking has not been carried out.AIMS: To study the pressure distribution inside the off-the-shelf orthopedic shoes“Sursil-Ortho” in comparison with the load inside the shoes used by patients on a daily basis.METHODS: We studied 20 patients (40 feet) with a high risk of diabetic foot syndrome. According to clinical data, a risk regions were determined on the plantar surface of the feet. In-shoe pedography (pedar, novel,Germany) was performed in shoes usually worn by the patients, and in orthopedic shoes“Sursil-Orto”(Moscow). The maximum peak pressure (MPP) was calculated. Criterion of efficiency: MPP in the risk region<200 kPa or reducing it by 25% or more.RESULTS: There was a significant decrease of the median MPP in the forefoot and in the risk region. The percentage of feet with MPP >200 kPa in the risk region decreased from 58% to 30% (p=0,014), in any area of the forefoot — from 63% to 30% (p=0,04). The increase in MPP under the midfoot and hindfoot did not exceed +14% (ns). Tested footwear was effective in 71% of cases. Predictors of the insufficient effect were: higher initial MPP in the risk region, risk region on the hallux or in the lateral part of the forefoot.CONCLUSIONS: Shoes with a rigid rocker outsole significantly reduce the pressure under the forefoot and under the toes during walking. The degree of load reduction varies: the lateral part of the forefoot and 2-5 toes are most unloaded, and the hallux and medial forefoot are slightly less.

Prevention of diabetic foot ulcers using a smartphone and mobile thermography: a case study

2021 ◽  
Vol 30 (2) ◽  
pp. 116-119
Author(s):  
Makoto Oe ◽  
Kahori Tsuruoka ◽  
Yumiko Ohashi ◽  
Kimie Takehara ◽  
Hiroshi Noguchi ◽  
...  
Keyword(s):  
High Risk ◽  
Diabetic Neuropathy ◽  
Diabetic Foot ◽  
Early Identification ◽  
Foot Ulcers ◽  
Monitoring Device ◽  
Diabetic Foot Ulcers ◽  
Self Monitoring ◽  
Care Incentives

Objective: Early identification of pre-ulcerative pathology is important to preventing diabetic foot ulcers (DFU), but signs of inflammation are difficult to detect on the feet of patients with diabetic neuropathy due to decreased sensation. However, infrared thermography can objectively identify inflammation. Therefore, a device that allows patients to visualise thermograms of their feet might be an effective way to prevent DFU. We aimed to determine the effects of a novel self-monitoring device to prevent DFU using a thermograph attached to a smartphone. Method: A self-monitoring device comprising a mobile thermograph attached to a smartphone on a selfie stick was created, and its effects in two patients with diabetic neuropathy and foot calluses assessed. Results: For one patient, he understood that walking too much increased the temperature in the skin of his feet (a sign of inflammation). The other patient could not detect high-risk findings, because the temperature of his skin did not increase during the study period. Conclusion: This device might provide self-care incentives to prevent DFU, although some issues, such as the automatic detection of high-risk thermographic changes, need to be improved.

scholarly journals Infrared thermography and ulcer prevention in the high‐risk diabetic foot: data from a single‐blind multicentre controlled clinical trial

2019 ◽  
Vol 37 (1) ◽  
pp. 95-104 ◽  
Author(s):  
N. L. Petrova ◽  
N. K. Donaldson ◽  
W. Tang ◽  
A. MacDonald ◽  
J. Allen ◽  
...  
Keyword(s):  
Clinical Trial ◽  
High Risk ◽  
Infrared Thermography ◽  
Diabetic Foot ◽  
Controlled Clinical Trial ◽  
Single Blind ◽  
Ulcer Prevention

Management of Foot Problems in Diabetes

1996 ◽  
Vol 16 (1_suppl) ◽  
pp. 279-282 ◽  
Author(s):  
Jonathan E. Shaw ◽  
Andrew J.M. Boulton ◽  
Ram Gokal
Keyword(s):  
High Risk ◽  
Diabetic Foot ◽  
High Risk Patient ◽  
Team Approach ◽  
Foot Care ◽  
Pressure Relief ◽  
Foot Complications ◽  
Foot Problems ◽  
Appropriate Education ◽  
Careful Management

Many diabetic foot complications are preventable. This requires a team approach, aiming to identify the high-risk patient and provide appropriate education and foot care. An established ulcer needs careful management with the emphasis on pressure relief and establishing a good blood supply.

scholarly journals Split-thickness skin grafting the high-risk diabetic foot

2014 ◽  
Vol 59 (6) ◽  
pp. 1657-1663 ◽  
Author(s):  
Jessica F. Rose ◽  
Nicholas Giovinco ◽  
Joseph L. Mills ◽  
Bijan Najafi ◽  
Jennifer Pappalardo ◽  
...  
Keyword(s):  
High Risk ◽  
Diabetic Foot ◽  
Skin Grafting ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Diabetic Foot Examination

2013 ◽  
Vol 61 (3) ◽  
pp. 136-136 ◽  
Author(s):  
Stephanie Thatcher Weinsier
Keyword(s):  
High Risk ◽  
Occupational Health ◽  
Diabetic Foot ◽  
Cost Effective ◽  
Clinical Settings ◽  
Foot Complications ◽  
Timely Fashion

The 60-second tool (2012)© uses a cost-effective, simple, standardized approach to identifying, in a timely fashion, which individuals are at high risk for diabetic foot complications. Using this tool, occupational health nurses can screen for diabetic foot complications in varied clinical settings.

scholarly journals Seek, and ye shall find: Efficacy of proactive screeningfor diabetic foot ulceration in the community autonomously performed by nurses

2020 ◽  
Vol 21 (Issue 1 Volume 21, 2020) ◽  
pp. 33-40
Author(s):  
Letizia Pieruzzi ◽  
Elisabetta Iacopi ◽  
Maria Grazia Buccarello ◽  
Ludovica Tamburini ◽  
Chiara Goretti ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Diabetic Foot ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Community Setting ◽  
High Morbidity ◽  
Care Model ◽  
Foot Ulceration ◽  
Financial Costs

Diabetic foot ulceration (DFU) is a severe complication of diabetes mellitus associated with a high morbidity and mortality rate, whose treatment requires considerable financial costs. This paper describes a test of the efficacy of proactive screening – autonomously managed by nurses in a community setting – in detecting patients at high risk of DFU, as an integrated part of a chronic care model strategy.

scholarly journals Diabetic foot and its serial treatment in high-risk patients: focusing on the individual

2020 ◽  
Vol 66 (11) ◽  
pp. 1542-1547
Author(s):  
Eli Ávila Souza Júnior ◽  
Raul Silva Simões de Camargo ◽  
Tiago Soares Baumfeld ◽  
Daniel Soares Baumfeld ◽  
Benjamin Dutra Macedo
Keyword(s):  
High Risk ◽  
Diabetic Foot ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
High Risk Group ◽  
Foot Care ◽  
Cross Sectional ◽  
High Risk Patients ◽  
Risk Patients ◽  
The Individual

SUMMARY Objectives: To assess knowledge about diabetic foot, care measures, and the importance attached to serial treatment in a group of high-risk diabetic foot patients. METHODS: This is a cross-sectional study, carried out in a tertiary hospital, with 25 patients undergoing serial treatment for diabetic foot. The tabulation of the data occurred through the use of three methodological figures: core idea, key expressions, and the collective subject discourse. RESULTS: It became evident that even among high-risk patients with diabetic foot, there is no complete knowledge about the definition of the disease. Despite this, all participants reported practicing daily care measures, including frequent inspection of the feet, food care, and attention to footwear. Regarding the importance of serial treatment, there was unanimous recognition of the relevance of this practice, which improves self-care discipline, optimizes the understanding of the disease, and helps to prevent progression. CONCLUSIONS: Authentic speeches in the context of a pathology of considerable prevalence manifested, in an unprecedented way, with conceptions about its definition, care measures, and importance of serial treatment in a high-risk group.

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