Some people have an underlying illness or condition that puts their legs and feet at increased risk of injury and disability. Various pathological conditions can reduce healing potential or produce increased risk of infection, necrosis, and ulceration High risk catagories are as follows:_
1.Vascular disorders, e.g. ischemia, arterial, venous and lymphatic (poor circulation) – leaves skin fragile and susceptible
2.Neurological disorders, e.g. Peripheral and central nervous system leading to sensory loss, deformity, alterations in gait such as Parkinsons, Multiple Sclerosis
3.Compromised immunity to infection such as Rheumatoid Arthritis, Diabetes Mellitus, Steroid drug therapy
4.Fluid retention due to chronic cardiac failure and venous incompetence
5.Malnutrition in the poor, the elderly or Asian cultures
6. Psychological disorder such as depression where the patient may not recognise that they have a foot problem
Once an injury occurs it can take a long time to heal. Some patients have reduced or no sensation in their feet due to Diabetes and they can injure themselves without knowing. For example, walking with a stone in their shoe for 30 minutes can result in ulceration.
Patients classed as high risk include some patients with diabetes, rheumatoid arthritis, cerebral palsy, peripheral arterial disease and peripheral nerve damage.
We provide assessment and treatment along with patient advice in order to reduce the long term and sometimes very serious problems that could lead to amputation. Our aim is to prevent complications leading to infection or injury, and to effectively manage established wounds, infection or necrosis, sometimes by referring on to the necessary NHS teams
Podiatry intervention can reduce amputation rates by 40%.