Home Forums Marketplace Table of Contents Events Member List Site Map Register Mark Forums Read



Welcome to the Podiatry Arena forums, for communication between foot health professionals about podiatry and related topics.

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members (PM), upload content, view attachments, receive a weekly email update of new discussions, earn CPD points and access many other special features. Registered users do not get displayed the advertisments in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

If you have any problems with the registration process or your account login, please contact contact us.


Tags:

Diabetes limb loss 'unnecessary'

Reply
Submit Thread >  Submit to Digg Submit to Reddit Submit to Furl Submit to Del.icio.us Submit to Google Submit to Yahoo! This Submit to Technorati Submit to StumbleUpon Submit to Spurl Submit to Netscape  < Submit Thread
 
Thread Tools Display Modes
  #1  
Old 28th March 2006, 11:02 PM
NewsBot's Avatar
NewsBot NewsBot is offline
The Admin that posts the news.
 
About:
Join Date: Jan 2006
Location: The Zoo, where all good monkeys should be
Posts: 13,383
Join Date: Jan 2006
Marketplace reputation 53% (0)
Thanks: 13
Thanked 580 Times in 470 Posts
Default Diabetes limb loss 'unnecessary'

Podiatry Arena members do not see these ads
The BBC are reporting:
Diabetes limb loss 'unnecessary'
Quote:
People with diabetes are having to have unnecessary lower limb amputations, a study has suggested.
Diabetes can lead to amputation because of damage to the nerves and blood vessels that serve the limbs.

People with diabetes are 15 times more at risk of lower limb amputation than people without the condition.

A study by Wolverhampton-based researchers showed too few were getting the right foot care, leading to the unnecessary limb loss.

Diabetes is the UK's second most common cause of lower limb amputation.

Data published by Diabetes UK shows up to 70% of people die within five years of having an amputation.

Lack of education:

Research presented at the Diabetes UK Annual Professional Conference in Birmingham looked at the care of people with diabetes prior to amputation.

A survey of 30 people with diabetes, aged between 60 and 80, who had had amputations, found 90% had been considered high risk in the period leading up to the procedure.

A history of ulcers, nerve damage, circulation problems and foot deformities can all put people at high risk of amputation.

But more than a quarter of those thought to be at high risk of amputation are not being offered any kind of specialist care, the Wolverhampton study suggested.

And two in five are not being educated on how to prevent and treat infections which can lead to amputation.

Over a third did not have any kind of diabetes review to assess how they managed their condition and to ensure they did not develop any other complications prior to amputation becoming a risk.

Foot checks:

Dr Baldev Singh, who carried out the research, said, "This research clearly shows that care for high-risk patients is inadequate. ...
Full story
Reply With Quote
Sponsored Links
  #2  
Old 29th March 2006, 12:43 AM
Cameron's Avatar
Cameron Cameron is offline
Podiatry Arena Veteran
 
About:
Join Date: Oct 2004
Location: United Kingdom
Posts: 585
Join Date: Oct 2004
Marketplace reputation 0% (0)
Thanks: 0
Thanked 13 Times in 12 Posts
Default

Netizens

I have a typeII diabtetic patient who has recently bumped the end of his foot against a step. The resultant lesion became infected and ulcerated. The infection has since cleared but the trophic ulcer on the apex of the great toe is now reached stasis with sloughpreventing healing. The ischaemic specialist wants to amputate and will decide in four weeks depending on what we can do meantime.

The lesion is currently debrided and washed with 0.9% sodium chloride solution and dressed with a dry sterile dressing. Reviewed every two days.

Any suggestions ?

Thank you in anticipation

Cameron
__________________

Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen
Reply With Quote
  #3  
Old 30th March 2006, 12:20 AM
Erp Erp is offline
Member
 
About:
Join Date: Oct 2004
Location: Melbourne, Australia
Posts: 14
Join Date: Oct 2004
Marketplace reputation 0% (0)
Thanks: 0
Thanked 4 Times in 3 Posts
Red face Preventing amputation

This could become a long answer, but I will try to keep it brief.
1. Complete assessment of neurovascular status: have they had ABI's and TBI's, this will indicate whether debridement of slough is viable. If they have critical limb ischaemia it is best left to the vascular surgeon to revascularise or amputate.
2. If vessels are patent, I would then check the cause: could more pressure from foowear be prevention healing: we now go to a CAM walker or air walker to completely off load the forefoot pressure, otherwise the open toed post op shoe could be a temporary option.
3. Dressings for this type of would wound involve a desloughing agent: a hydrogel such as intrasite gel or solosite gel(smith & nephew) would break this down if you can't debride it with a scalpel. We would then apply an absorbing dressing such as a foam (allevyn or biatain) to absorb exudate and protect the area. Secure with hypafix tape or whatever the patient is not allergic to.
4. Educate the patient until they can repeat back what you have told them and have it all written down as they can show carers, nurses, etc to confirm the treatment required.
5. If not already done, swab the wound and check for microbes which could delay healing even if the wound is not showing signs of clinical infection, it could be colonised.

This is the tip of the iceberg, but it's important to communicate with all parties involved to ensure best practice and prevent the amputation.
The international consensus on the diabetic foot is a great reference to use for supporting what you are doing and why.
www.iwgdf.org

Good luck!
ERP.
Reply With Quote
  #4  
Old 30th March 2006, 02:14 AM
Cameron's Avatar
Cameron Cameron is offline
Podiatry Arena Veteran
 
About:
Join Date: Oct 2004
Location: United Kingdom
Posts: 585
Join Date: Oct 2004
Marketplace reputation 0% (0)
Thanks: 0
Thanked 13 Times in 12 Posts
Default

Many thanks ERP and I will keep you posted of developments

Cameron
__________________

Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen
Reply With Quote
  #5  
Old 30th March 2006, 03:20 PM
Tuckersm's Avatar
Tuckersm Tuckersm is offline
Podiatry Arena Veteran
 
About:
Join Date: Nov 2004
Location: Melbourne, Australia
Posts: 674
Join Date: Nov 2004
Marketplace reputation 0% (0)
Thanks: 98
Thanked 130 Times in 110 Posts
Default

Cameron,

We have found the use of Cadexomer Iodine very useful in desloughing areas

more info from Smith & Nephew
__________________
Stephen Tucker
Manager, Specialist Clinics



My location
Reply With Quote
  #6  
Old 30th March 2006, 04:10 PM
Cameron's Avatar
Cameron Cameron is offline
Podiatry Arena Veteran
 
About:
Join Date: Oct 2004
Location: United Kingdom
Posts: 585
Join Date: Oct 2004
Marketplace reputation 0% (0)
Thanks: 0
Thanked 13 Times in 12 Posts
Default

Cheers

Cameron
__________________

Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen
Reply With Quote
  #7  
Old 30th March 2006, 04:51 PM
dbelyea dbelyea is offline
Member
 
About:
Join Date: Feb 2005
Location: Australia
Posts: 8
Join Date: Feb 2005
Marketplace reputation 0% (0)
Thanks: 0
Thanked 1 Time in 1 Post
Default x-ray

I would also send the pt off for bilateral x-rays, if not already done. There is always a chance of osteomyelitis, which will delay healing. Periostial reaction and bony destruction can take several weeks to show up on x-rays. It’s always good to have baseline films.

If there is any doubt the pt should then be sent for technetium and labelled white cell bone scans.
Reply With Quote
  #8  
Old 31st March 2006, 01:04 AM
Cameron's Avatar
Cameron Cameron is offline
Podiatry Arena Veteran
 
About:
Join Date: Oct 2004
Location: United Kingdom
Posts: 585
Join Date: Oct 2004
Marketplace reputation 0% (0)
Thanks: 0
Thanked 13 Times in 12 Posts
Default

Many thanks dbelyea and everyone else who has corresponded

Cheers
Cameron
__________________

Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen
Reply With Quote
Reply



Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts
vB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump

Translate This Page

Similar Threads
Thread Thread Starter Forum Replies Last Post
Is Alzheimer's a New Form of Diabetes? Admin General Issues and Discussion Forum 19 25th October 2013 02:42 PM
Height is a predictor of diabetes amputations NewsBot Diabetic Foot & Wound Management 1 15th August 2006 02:20 AM
Diabetes and Tai Chi execise Study Ian Linane Diabetic Foot & Wound Management 1 6th January 2006 02:47 PM


New To Site? Need Help?

Finding your way around:

Browse the forums.

Search the site.

Browse the tags.

Search the tags.


All times are GMT -7. The time now is 10:53 AM.