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Amputation Prevention

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Prevention of diabetic foot amputation and support:John august:"Remove your shoes for short periods when you can. Do not wear bedroom slippers when you should wear shoes. Slippers do not give proper support. Do not step on the floor or go outside with bare feet. Wear shoes of soft leather that fit but are not tight. Break in new shoes gradually 1 hour a day. Use cotton bed socks if you need extra warmth for your feet when you are in bed to sleep, but do not use hot water bottles or electric heating pads. Don't burn your feet! Electric blankets are okay. Do not wear garters or sit with your legs crossed. Either will decrease circulation to your feet, and the circulation may already be less than normal because of the effect diabetes may have on your blood vessels."
http://members.tripod.com/~johnaugust/footproblems.html

Prevent foot ulcers and amputations-click to start your journey:ELI LILLY AND COMPANY:"Welcome to the Diabetes Resource Center! This site was developed by Eli Lilly and Company. The purpose of this resource center is to provide easy steps for healthy foot care. By increasing the importance of daily foot exams, most diabetic foot ulcers and amputations can be prevented. A diabetes foot check should be performed by your healthcare team at every visit. Your nurse or doctor will check your feet for bruises, cuts, scrapes, calluses, red spots or signs of infection. the exam should include a test to see if you have any loss of feeling, circulation problems or changes in the shape of your feet."
http://www.diabetesresource.com/

Aggressive risk management and ulcer treatment to avoid amputation:postgradmed:"Every year, 7 or 8 of every 1,000 Americans who have diabetes undergo amputation of a foot. The rate may be twice as high in African Americans as in whites and even higher in Hispanic and Native Americans. In all diabetic patients, the rate of amputation increases with age and duration of the disease. Clearly, attentive and rigorous care is needed in these patients. In this article, Dr Muha summarizes risk factors for foot complications and describes comprehensive evaluation of foot ulcers. He also discusses the several objectives of successful treatment (eg, pressure reduction, wound closure) and how to achieve them."
http://www.postgradmed.com/issues/1999/07_99/muha.htm

Taking diabetic foot care into the new millennium:Clinical Geriatrics:"Nonhealing foot ulcers are the leading cause of such complications in patients with diabetes as infection and amputation. This article offers a review of the pathophysiology of diabetic ulcers, as well as the traditional methods for treating them. It also introduces the newer methods, including hyperbaric oxygen therapy and recombinant platelet-derived growth factor-BB. With a multidisciplinary team approach to diabetic care and the integration of traditional and new wound-healing technologies, the goal is a 40% reduction in diabetic amputations by the year 2000"
http://www.mmhc.com/hhcc/articles/HHCC9903/Millington_hhcc.html

Preventing amputation with warm up therapy:woundcare.org:"There was no odor from the wound and the patient reported the wound was not painful. On April 17, 1999, the patient was referred by a physician for Warm-Up® wound therapy to salvage her foot and prevent an amputation. After application of the Warm-Up® active wound therapy® system for seven weeks, the patient’s wound was resolved with a significant savings realized by preventing an amputation. Furthermore, salvage of the foot allowed the patient to maintain an unrestricted lifestyle - avoiding the effects of long-term disability and de-conditioning."
http://www.woundcare.org/newsvol5n3/ar6.htm

Diabetic foot complications book:Paul Y Han:"A Comprehensive Guide to educate diabetics about critical foot care and treatments. Written specifically to help prevent toe, foot and leg amputations. Includes self-assessment tests, actual case histories, and over 100 photographs of foot problems and treatments. "
http://www.mol.net/md/paulhan/book/default.htm

The diabetic foot:The Medico-legal advisor:"Here is one typical scenario involving the diabetic foot: The patient, and adult diabetic with peripheral neuropathy and ischemia, goes to a podiatrist to have his corns trimmed. The area ulcerates and is debrided. The patient seeks the help of his family practitioner and is put on soaks and oral antibiotics. The ulcer grows and by the time he is referred to a surgeon he has a large infected ulcer and osteomyelitis. He loses a couple of toes or a foot or a leg. The acts of negligence are easily defined. First off, the foot of the diabetic requires exquisite care. Corns or other lesions should be removed very cautiously and superficially. Surgery on the diabetic foot should only be done after it is established by vascular studies that the patient has reasonable vascular supply and prophylactic antibiotics are considered. "
http://www.drdry.com/foot.html



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Last updated by Andrew Lopez, RN on Wednesday, September 29, 2010


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