Originally Posted by Graham
I think you will find many Pods dealing with the "diabetic foot" have been using dermal thermometry for many years as an adjunct to their other assessment measures.
Happy new year buddy!
I think there are 2 important riders to this.
1 unreliable with significant iscaemia
2 Although I recommend use of "temp touch" as a matter or course to those with loss of protective sensation but no ischaemia I have stopped doing so when significant hyperkerotis forms at weight-bearing sites.
I have had a couple of patients who are are high risk for lower extremity amputation because of loss of protective sensation with no evidence of iscaemia who were insensitive to temperature gradient testing using end of day home "temptouch" IR dermal temp monitoring. Both had prior history of osteomyelitis secondary to neglected neuropathic ulceration with resultant deformity and limb threatenning pressure distribution issues.
The problem seems to me that with hyperkeratosis formation at the high risk zones, temperature gradient is likely obscured. I checked these ulcerated lesions (ulcer appears superficial non-infected non ischaemic not involving tendon, joint capsule or bone UTDWCS grade IA ulcer sites) pre debridement with my office "dermatemp" and found similar problems with lack of temp gradient so I don't think it was a defect in "temptouch" product.
I am unaware of any research on this issue; any comments?
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