Prevent and care for foot wounds

One pair must last a lifetime – take good care of them and they will look after you
With the rising incidence of diabetes it is essential that everyone has a greater understanding of what constitutes good foot care. People suffering from diabetes have greater risks of sustaining injuries to their feet and these foot wounds may take much longer than normal to heal and be associated with more complications.

Suggestions for preventing foot wounds include

• Inspect feet daily, using a mirror for difficult to-see areas. If there are problems with eyesight or access, then a relative may be able to assist.
• Palpate the feet looking for any rough ‘thick’ skin as this is indicative of excessive pressure.
• Feel for temperature changes or areas of tenderness and this could indicate a reduced circulation.
• Wash feet daily and dry thoroughly. Do not soak feet or use strong astringents.
• If skin is dry moisturiser can be applied but not between the toes to prevent infections.
• If possible when older, have a trained podiatrist cut toe nails and care for any rough areas of skin. Under an Enhanced Primary Care (EPC) plan, your GP can refer you to a podiatrist for 5 heavily subsidised/free visits.
• Preferably do not walk about without some form of footwear to protect your feet from damage.
• Do not place very hot objects e.g. hot water bottle, over feet or sit too near hot or very cold objects as burns may result from the reduction in sensation experienced by some patients.
• Do not self treat corns as more damage may result.
• Ensure the shoes accommodate the feet without causing any reddened areas, ideally the shoes for elderly will have extra depth and extra width, and lace up so that if swelling occurs the laces can be opened up and the foot comfortably placed in the shoe rather than being squeezed in.

If a wound on the foot fails to improve within one week it is suggested that further advice is sought from a health specialist or podiatrist. Often the non-healing wound may be the first sign that diabetes is present.

Wounds on feet require ‘off-loading’ or protection against further pressure. Management of wound ooze is important to prevent the skin becoming soggy and antimicrobial dressings will reduce the bacterial count.

Wound cleansing solutions may assist in breaking down biofilms and combatting micro-organisms that cause infection. Then antimicrobial dressings such as iodine, silver, tea tree oil, enzymes or honey dressings may assist in managing any bacteria contained within the wound.

Regular dressings and trying not to put any increased pressure on the wound are necessary to successfully heal the wound in a reasonable time frame.