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How to Prevent Foot Ulcers and Amputations

Simple, Two-minute Check Can Prevent Foot Ulcers and Amputations

 
Dr Timothy Ford is a podiatric surgeon based in Louisville, KY, and directs the Reconstrucive Foot/Ankle Surgery & Diabetic Limb Salvage/Preservation Fellowship @ Jewish Hospital and the University of Louisville Hospital. He urges all local diabetic patients to make sure their physicians check their feet during every office visit for signs of ulcerations that, left untreated, can lead to infection and ultimately result in lower limb amputations. Ford first issued this advice in conjunction with National Diabetes Month in November but stressed it is sound practice year-round.
 
"It's a simple exam that takes two minutes to determine if the patient is at risk for foot ulcers," said Dr Ford, a member of the American College of Foot and Ankle Surgeons (ACFAS) . "And the easiest way to remember to get your feet checked is to remove your shoes and socks in the examining room before the doctor comes in," he added.
 
Most diabetic patients are vulnerable to foot ulcerations caused by poor blood circulation in the lower extremities and neuropathy that inhibits nerve sensation. "Ulcers are the leading cause of foot amputations among people with diabetes and they are preventable in most cases if doctors routinely check their patients feet," said Dr Ford. "It's so tragic when I encounter someone who undergoes an amputation that could have been prevented by regular, two-minute foot exam."
 
It is estimated that more than 86,000 lower extremity amputations are performed in the United States every year on patients with diabetes. More than 70 percent of them are caused by foot ulcerations that deteriorate to deep tissue infection, tissue necrosis and gangrene.
 
In foot exams performed by primary care physicians or podiatrists, patients should be checked for nerve sensation, skin irregularities (corns, calluses, punctures and areas of redness), swelling, drainage, and foot deformities that cause unnatural pressure points that are prone to ulceration. In cases of deformities such as bunions and hammertoes, diabetic patients should consult a podiatric surgeon to determine the best treatment option to reduce possible downstream risk for ulceration, infection or amputation.
 
Individuals considered at high risk for foot ulcers should have their feet checked every two to three months, but all diabetic patients should be checked at least twice a year. "It doesn't take long for infection to worsen and ulcers to occur without the patient being aware that anything is wrong. Diabetes carries an enormous health care burden, but being diligent about foot care is a prudent and simple way to avoid one crippling complication of this disease.
 
ACFAS offers a free brochure, "Diabetic Foot Problems and Treatments which is available by calling the College toll-free at 888 THE FEET or on the web at www.acfas.org