DIABETIC FOOT CARE - PowerPoint PPT Presentation

View by Category
About This Presentation
Title:

DIABETIC FOOT CARE

Description:

DIABETIC FOOT CARE DIABETES REDUCES SENSATION WHICH CAN ... FOOT CARE DIABETIC FOOT CARE AND EDUCATION PowerPoint Presentation PowerPoint Presentation ... – PowerPoint PPT presentation

Number of Views:1773
Avg rating:3.0/5.0
Date added: 23 July 2020
Slides: 44
Provided by: IKFR
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: DIABETIC FOOT CARE


1
DIABETIC FOOT CARE
  • BAGIAN ILMU KEDOKTERAN FISIK DAN REHABILITASI
  • RS DR. HASAN SADIKIN
  • BANDUNG

2
INTRODUCTION
  • 15 DIABETIC PATIENTS WILL SUFFER FOOT PROBLEMS
  • RISK FACTOR MAJORITY OF PATIENTS WITH TYPE 2 DM
    AND LONG STANDING TYPE 1 DM
  • 45 OF ALL MAJOR AMPUTATION CAUSED BY DIABETIC
    FOOT SYNDROME

3
INTRO.
  • DEATH CAUSED OF FOOT DIABETIC 17-32
  • GOOD DIABETIC FOOT CARE WILL DECREASE AMPUTATION
    IN ½ - ¾ CASES

4
DEFINITION OF DIABETIC FOOT SYNDROME
  • FOOT ABNORMALITIES CAUSED BY NEUROPATHY,
    ANGIOPATHY AND INFECTION IN DIABETES MELLITUS
    PATIENTS

5
COMMON FOOT PROBLEMS
CHARCOT JOINT
HAMMER TOE
HALUX VALGUS
ULCER
6
INGROWN TOENAILS
CORN CALLUS
7
DM
Peripheral neuropathy
Peripheral vascular disease
Increase flow regulation
motor
sensory
Autonomic
pain ? proprioception ?
Shunting
sweat ?
Power imbalance
Reduced capillary blood flow
Fissuring ?
Deformity
Defective response to start foot ulcer and
infection
8
PERUBAHAN TEKANAN PADA KAKI
MONOFILAMENT TEST
9
NEUROPATI
DEEP TENDON REFLEX TEST
TUNING FORK VIBRATORY SENSE
10
ANGIOPATHY
  • PULSASI ARTERI DORSALIS PEDIS

11
MANAGEMENT GOAL FOR DIABETIC FOOT
  • ACUTE
  • WOUND HEALING
  • SAFE THE FOOT FROM AMPUTATION
  • CHRONIC
  • TO PREVENT RECURRENCY OF WOUND

12
GRADING ULCER (WAGNER CLASSIFICATION)
13
OBJECTIVE
LEVEL I
Neuropathy
No wound
LEVEL II
Neuropathy Deformity
Wound free
Neuropathy History of wound/amputation
Treat the wound early No recurrent wound No
amputation
LEVEL III
Neuropathy bone disorganization
LEVEL IV
Wound free No amputation
14
LEVEL I
Neuropathy
Objective No wound
Intervention and plan of treatment
General foot care Appropriate foot wear
15
LEVEL II
Neuropathy Deformity
OBJECTIVE WOUND FREE
Intervention and plan of treatment
Foot care Preventive surgery Protective
foot wear
16
LEVEL III
Neuropathy History of wound/amputation
ObjectiveTreat wound early, no recurrent wound
no amputation
Intervention and plan of treatment
Foot care Treat the wound by off loading
Tech. Surgery (for complicated wound)
17
LEVEL IV
Neuropathy Bone Disorganization
Objective Wound free No Amputation
Intervention and plan of treatment
Intensive foot care Rehabilitation a.
Conservative treatment b. Reconstructive
Surgery Protective footwear
18
LONG TERM CARE
  • TO PREVENT RECURRENT WOUND
  • EDUCATION
  • DIABETIC FOOT CARE

19
DIFFERENTIATION OF THE FOOT
  • DIABETIC FOOT
  • Damaged Nerves ? difficult to feel pain,
    pressure, heat and cold.
  • Blocked Blood Vessels bring fewer nutrients and
    oxygen to feet ? sores may not be able to heal.
  • Weakened Bones may slowly shift, causing foot to
    become deformed and changing the way distributes
    pressure.
  • Collapsed Joints, especially a collapsed arch,
    can no longer absorb pressure or provide
    stability. The surrounding skin may begin to
    break down.
  • HEALTHY FOOT
  • Nerves let you feel pain, vibration, pressure,
    heat, and cold
  • Blood Vessels Carry nutrients and oxygen to your
    feet to nourish them and help them heal from
    injuries.
  • Bones give your foot shape and help distribute
    the pressure from your body's weight.
  • Joints are the connections between your bones.
    They help absorb pressure and allow your foot to
    move. Your arch is a group of joints that
    provides stability for you entire foot

20
DIABETIC FOOT CARE
DIABETES REDUCES SENSATION WHICH CAN LEAD TO
INJURIES
Blisters or Calluses start as red or warm spots.
They are often caused by unrelieved skin pressure
Ulcers (sores) may result if blisters or calluses
reach the skin's inner layers. Ulcers may become
infected.
Bone Infection may occur if infected ulcers
spread. Untreated bone infections may lead to
loss of foot.
21
DIABETIC FOOT CARE AND EDUCATION
  • CHECK YOUR FEET EVERY DAY
  • DO YOUR SEE RED SPOTS ?
  • DO YOU HAVE BLISTERS OR CALLUSES ?

22
CARE AND EDUCATION
IRRITATIONS, SKIN LESIONS
BLISTER
CUTS BETWEEN YOUR TOES
23
  • DO YOU FEEL TINGLING?
  • ARE YOUR FEET COLD?
  • ARE YOUR FEET NAILS INGROWN?
  • HAS YOUR ARCH DECREASED?

24
CARE AND EDUCATION
  • TEST THE TEMPERATURE OF THE WATER BEFORE PUTTING
    YOUR FEET
  • WASH YOUR FEET WITH LUKEWARM WATER AND MILD SOAP

25
CARE AND EDUCATION
  • KEEP SKIN SUPPLE MOISTURISED
  • CUT YOUR NAIL CORRECTLY
  • Do not cut the corner of your toe nails

26
CARE AND EDUCATION
  • DO NOT WALK BARE FOOT

27
EXAMINE YOUR FEET DAILY
  • DRY YOUR FEET PROPERLY
  • DO NOT SOAK MORE THAN 5 MINUTES

28
DIABETIC SHOES
29
How To Select The Right Shoes?
30
GOOD DIABETIC SHOES..
  • Both feet measures
  • Deep and wide toes box
  • Flexible rubber soles
  • Cushioned insole, 0.5-1 cm thick and softness

31
GOOD DIABETIC SHOES..
  • Deep wide enough to accommodate the foot
  • A firm heel counter/Back strap
  • Adjustable by laces/velcro fasteners to keep the
    shoe on the foot securely
  • Acceptable to the patient in appearance, cost
    function

32
TYPE OF FOOTWEAR
Custom Molded Shoes With Insoles
33
TYPE OF FOOTWEAR
Molded Sandal
34
WARNING SIGNS AND SYMPTOMS OF DIABETIC FOOT
PROBLEMS
35
REMEMBER
  • EXAMINE YOUR SHOES
  • BEFORE PUTTING THEM ON
  • DONT ATTEMPT SELF TREATMENT
  • SEEK IMMEDIATE MEDICAL ATTENTION

36
THANK YOU
  • HATUR NUHUN

37
Type of Footwear
Molded Insole
1. Increasing wt.bearing area 2. Assist the foot
in normal function
38
Metatarsal bar
39
(No Transcript)
40
(No Transcript)
41
PATOGENESIS
42
DIABETIC FOOT LESION GRADING SYSTEM - WAGNER
43
MANAGEMENT
About PowerShow.com