FOOT CARE GUIDELINES:

• Wash and dry feet well every day
• Wear well fitting shoes and clean, dry, cotton shocks.
• Never walk barefoot.
• Follow the contour of toe when trimming toe nails. To prevent ingrown nails, do not cut into the corners.
• Apply moisturizing lotion daily.
• Avoid using lotions that are perfumed or that contain alcohol.
• See a podiatrist regularly for removal of corns, warts and calluses.
• A yearly foot evaluation is recommended.
• Buy shoes mid day, when feet are their largest. Break in new shoes gradually.
• Leather shoes will stretch and mold to the foot and provide less pressure areas.
• Notify your health care provider within 24 hours if your foot becomes infected or injured.
• Keep the area clean, dry and covered.
• Apply antibiotic ointment and gauze wrap as needed. Try to stay off the foot as much as possible until it is evaluated.

Feet First

Source: Times of India
The boots of the city's policemen, part of the uniform introduced by the British, are now a major worry for them. Around 80% of police personnel in the city, according to sources at the police hospital, either have vascular problems or develop corns because of these boots.

They are unsuitable for the city's weather conditions and cause conditions like varicosis (enlargement of varicose vein which circulates blood from the legs) and varicose ulcers. The latter ailment, like diabetic ulcers, could lead to amputation if not treated on time, sources told TOI.

"The badly-fitting boots obstruct the re-flow of blood from the legs. Compounding this is the excess sweating caused by the boots of inferior quality leather. This leads to skin irritation which then turns into rashes and wounds, causing ulcers. We perform varicose ulcer surgeries on a weekly basis," a doctor at the police hospital said.

Police personnel, especially those in the lower ranks, are forced to wear these boots, sourced and supplied to them by the department.

Given that varicose ulcer is a major health hazard, policemen with the problem are urged to get admitted to hospital and undergo treatment. "We dress up the wound if it is at the beginning stage and make them lie down with their legs lifted up. They need a fair amount of rest in this position," doctor said.

More hospitalizations mean more trouble for the already short-staffed city police. "Some of the sick policemen approach us for postings at police outposts in hospitals so that they can get medical aid fast," a senior official said.

"The boots are of poor quality and often we do not get boots of our size. Some of those that are of the correct size do not fit properly. The leather is also of inferior quality. We are forced to wear these boots for long hours and very often we get skin rashes due to excess sweating in the extreme hot climate," a constable said.

Many constables told TOI that they dumped the boots provided by the department and bought better products from the open market. "We spend money from our pocket and purchase boots in the open market. Many of us have suffered from these boots for the past few years and we do not want to take anymore risks. The authorities are aware of the problem but they are not ready to rectify it," an inspector said.

To tackle these kinds of problems MV Hospital for Diabetes and Diabetes Research Centre, Royapuram Chennai headed by Dr Vijay Viswanathan provides routine integrated examination of the feet of diabetic patients. New types of foot wear are prepared at M.V.Hospital, Royapuram with technical assistance from Central Leather Research Institute (CLRI) Chennai for diabetic patients with foot complications.

Also special foot wear made up of new types of insole materials for patients with high risk foot. Lightweight, inexpensive and aesthetically appealing, this footwear will be extremely beneficial to diabetes that require specialized footwear to prevent pressure points on the feet from developing into calluses and ulcers that could get infected.

Disclaimer: All opinions and Information published here is for medical education only. It is not intended as and does not substitute for medical advice. If you are a patient, please see your doctor for evaluation of your individual case. Under no circumstances will the authors be liable to you for any direct or indirect damages arising in connection with use of this website

Monsoon sets in and so do foot infections

This article has been published in Deccan Chronicle on Sept 12, 2008
Be Alert
-->About 50 per cent of all non-traumatic amputations are due to diabetes-related foot ulcers.
-->Globally, an amputation is performed due to foot infection, every 30 seconds.
-->Patients should never walk bare foots, even inside the house. They should wear right footwear, preferably made of microcellular rubber.

With the onset of rain city doctors are witnessing a sharp upswing in the number of diabetics’ patients with foot infections-and a gross lack of awareness is to blame, they say.

“The feet are highly vulnerable to infection in diabetics due to a nervous condition called ‘neuropathy’ that causes loss of sensation,” said Dr Vijay Viswanathan, Diabetologist, MV Hospital for Diabetes, where at least two major amputation are performed everyday.

While 40 percent of all patients develop neuropathy within five to ten years of developing diabetes, smoking and excessive alcohol speed up the process.

The monsoon triggers a spurt of foot infection with people wading in water, and staying in wet shoes and shocks, inviting fungal infection between the toes. Patients who do not have their diabetes under control are the worst hit, as even a tiny pinprick can cause devastating damage. Infections like ‘athlete’s foot’ can be very harmful in a diabetes patient, as their healing capacity is low.

“Several patients get infected when they mistakenly cut into the skin, while trimming their toes nail. Diabetes with neuropathy should only file their nail do not cut them,” cautions Dr Ratnavel, Professor of Dermatology and Cosmetology, Stanley Medical College.

Wearing wrong footwear, not drying wet foot properly and walking bare foot even inside house are the most common reason for foot infections. A rise in the incidence of foot ulcer is also seen in summer, when people tend to visit temples, bare foot.

“Foot infections often recur, sometimes even thrice a year. Each time, the infected part has to be cut into, sutured and dressed. Hospitalization is required and the patient has to shell out a minimum of Rs 60,000. All for a condition that can be prevented with little care” Dr Vishwanathan concludes.

Disclaimer: All opinions and Information published here is for medical education only. It is not intended as and does not substitute for medical advice. If you are a patient, please see your doctor for evaluation of your individual case. Under no circumstances will the authors be liable to you for any direct or indirect damages arising in connection with use of this website

Vaccum Assisted Closure (VAC)

The latest in Diabetic foot wound healing ……..now at M.V. Hospital

Diabetic foot ulcer is a cause for enormous suffering, loss in economic productivity and mortality. The outcome is poor because of the severity of the disease. Management is often sub optimal because of poor understanding of the subject and it is unfashionable and generally omitted from professional training and largely neglected in research. The result is that ignorance is endemic; management is guided by belief and habits more than by evidence and research allocation is minimal. The technology has been revolutionized and recent advances are a boon to man-kind. One such example is VACCUM ASSISTED CLOSURE device which works on the principle of negative pressure wound therapy (NPWT). It involves the delivery of intermittent or continuous sub-atmospheric pressure through a specialized pump connected to the wound surface maintaining a closed environment. The pump is connected to a canister, which serves to collect wound discharge and exudates. Studies have shown that VAC therapy system yielded a higher proportion of healed wounds, faster time to wound closure, a more rapid and robust granulation tissue response and reduced risk for a second amputation. Keeping pace with time and technology, the VAC system has been introduced recently at our centre. We at M.V. Hospital are using this technology in treating diabetic foot ulcers and have achieved good results. VAC therapy is indicated in larger, deeper and partial foot amputation wounds. However, they are contraindicated in small wounds responding to debridement.

Disclaimer: All opinions and Information published here is for medical education only. It is not intended as and does not substitute for medical advice. If you are a patient, please see your doctor for evaluation of your individual case. Under no circumstances will the authors be liable to you for any direct or indirect damages arising in connection with use of this website