DEFINITION

To the patients of risk (elders and those that have bad circulation), there is recommended to them the following routine care of the feet:

Every day, the feet must be washed (although not soaked) in warm water, which temperature has been proved previously with the hand. They must dry off with fastidiousness, paying a special attention to the interdigital spaces (between the fingers).

The fingernails of the feet must be cut carefully. The patients with bad sight or tremulous hands must ask others persons that they should be cut. The fingernails must not be shorter than the point of the finger.

The feet must be inspected often, looking thoroughly for very dry areas and fissures in the skin, especially about the fingernails and in the interdigital spaces. They must be dusted by talc, if the skin is humid, or be covered with moisturizer, if the skin is dry. The plants must be inspected by a mirror or for another person. One must be specially careful with the tripe and the hardnesses, which must be attended by a podiatrist. Neither (iodine), nor corn removers must be used antiseptic powerful.

If blisters or infections appear, the doctor must be consulted immediately.

Bags of warm water must not be used. It is preferable to use a few socks.

Electrical blankets can be used, but they must go out before getting into the bed.

The shoes must fit well (without being too tight) and being comfortable, leaving space so that the fingers rest in his natural position.

The new shoes must put on progressively, every time during an a little longer time.

Cotton socks or wool must be used, better than of nylon. They must be of the suitable size and not have neither darning nor seams that could produce pressures. They must change every day.

To walk with the barefooted feet is dangerous, since a small wound can be late very much in be treating.

The tobacco is very harmful to the diabetics, because it produces vasoconstricción.

Another aspect of the prevention that certain attention deserves, is the footwear design to measurement for the diabetics with very vulnerable feet. These shoes must be designed to redistribute the forces that the foot supports.

CARE OF THE ALREADY EXISTING INJURIES

It is necessary to do a detailed examination of both feet, with a careful examination of the heels and the interdigital spaces. The state of the circulation, and sensibility they must be evaluated in detail. There must be born in mind the temperature and the color of the skin, the vascular answer to the elevation of the member, that is to say if changes take place in the color as the position of the extremity, the change in the quantity of hair of the leg. A color photograph is useful to be able to judge the progression of the absence of irrigation. The treatment of the diabetic foot is based in:

• Protection from the damage that collaborates to the loss of sensibility caused by injury of the peripheral nerves.
• Treatment of the infection that could appear.
• Improvement of the circulation avoiding the use of footwear or exact pledges.
• Metabolic control of the diabetes, that is to say, to verify that the glucose levels are inside the authorized limits.

WHAT DOCTOR CAN TREAT ME?

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