Foot care

Definition

Foot care involves all aspects of preventive and corrective care of the foot and ankle. Physicians specializing in foot care are called podiatrists.

Purpose

During an average lifetime, each person walks about 115,000 miles; and 75% of all people have foot problems at some point in their lives.

Foot problems can arise from wearing ill-fitting shoes, from general wear and tear, as a result of injury, or as a complication of disease. People with diabetes mellitus or circulatory diseases are 20 times more likely to have foot problems than the general public.

Podiatrists specialize in treating the foot and ankle. Other doctors who have experience with foot problems are family physicians, orthopedists, sports medicine specialists, and those who care for diabetics. Problems with the feet include foot pain , joint inflammation, plantar warts, fungal infections such as athlete's foot, nerve disorders, torn ligaments, broken bones, bacterial infections , and tissue injuries such as frostbite.

Precautions

People with diabetes or circulatory disorders should be alert to even the smallest of foot problems. In this patient population, a break in the skin can lead to possible infection, gangrene , and amputation .

Description

Daily foot care for people likely to develop foot problems includes washing the feet in tepid water with mild soap and moisturizing the feet with lanolin-based lotion. Toenails should be cut straight across above the level of the skin after soaking the feet in tepid water. Corns and calluses should not be cut. If they need removal, it should be done under the care of a doctor. If they develop in high-risk patients, athlete's foot and plantar warts should also be treated by a doctor.

Many people with diabetes or circulatory disorders suffer with the problem of cold feet. A problem with cold feet can be helped by not smoking (it constricts the blood vessels), not crossing the legs while sitting or sitting in one position too long, wearing warm socks, and avoiding constricting stockings. People with circulatory problems should not use heating pads or hot water bottles on their feet, as even moderate heat can damage the skin if the circulation is impaired.

The patient who is at risk for foot problems should also choose socks that are soft and cushioned. Cotton material is best at wicking moisture away from the feet. Good shoes should be worn whenever the patient is ambulating or out of bed. Flat shoes are preferred, and the fit should allow about 0.75 inch (about 2 cm) between the end of the big toe and the shoe. The patient should not walk barefoot.

A routine part of foot care includes an assessment of the feet for changes or injury. These can include blisters, cuts, redness, scratches, or other breaks in the skin.

Preparation

No special preparation is necessary other than understanding the nature of foot problems.

Aftercare

Foot care is preventative and should be ongoing throughout a person's life.

Complications

There are no complications associated with foot care. The risks are in ignoring the feet and allowing problems to develop.

Results

With regular care, foot disorders such as infections, skin ulcers, and gangrene can be prevented.

Caregiver concerns

The nurse plays an important role in identifying patients at risk for foot problems and in providing foot care. The patient should be instructed on appropriate foot care and the measures that can be taken to prevent complications.

Resources

PERIODICALS

“Preventive Foot Care in People with Diabetes.” Diabetes Care 23 (January 2000): 55.

Roberts, Shauna S. “Caring for Feet.” Diabetes Forecast 53 (January 2000): 10.

“Secrets of Preventing Foot Problems.” Diabetes Forecast 54 (February 2001): 71.

ORGANIZATIONS

American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) DIABETES. http://www.diabetes.org.

Deanna M. Swartout-Corbeil R.N.