|
| Patients
with various diabetic complications are referred to our centre . Our centre
is one of the largest diabetic centres in Asia. The foot care department
of our centre is actively involved in the treatment and research of diagnostic
foot problems. The services and facilities available are given in the following
paragraphs |
| |
| STAFFING
PATTERN |
| The
multi-disciplinary foot care team includes the Diabetologist, Orthotist,
Foot educator, Foot lab technicians, Pedicurist, General, Orthopedic and
Vascular surgeons. |
| |
| Foot
Department |
|
|
| Co-ordinator |
: |
Dr.
Vijay Viswanathan |
| Podiatric Surgeon |
: |
Dr.Rajesh Kesavan |
| Podiatric Asst. |
|
Ms.Kavitha |
| Foot
Educator |
: |
Mrs.
Seena Rajasekar / Mrs. Sivagami |
| Pedicurist |
: |
Mrs.
Abirami |
| General
Surgery |
: |
Dr.
R. Venkatagopalakrishnan, Dr. Jacob |
| Vascular
Surgery |
: |
Dr.
Sekar, Dr. Ilayakumar |
| Orthopedic
Surgery |
: |
Dr.
S. Chandrasekaran |
| Plastic
Surgery |
: |
Dr.
Balakrishnan |
| Foot
Lab Technicians |
: |
Mrs.
Ezhilarasi, Ms. Geethalakshmi, Mrs. Rekha |
|
| FACILITIES
& SERVICE |
| The
clinic has the required facilities and Staff to provide the following services.
(a)
Education of Patients & Carers,
(b)
Timely detection of high risk foot through routine foot examination by
specially trained staff capable of recognizing
risk factors for ulceration and amputation,
(c)
Measures to reduce risk, including podiatry, appropriate footwear and vascular
and orthopedic interventions,
(d)
Prompt and effective treatment of active problems, including ulcers, infection
and ischemia. |
|
| Early
diagnosis |
Foot problems
are diagnosed at a very early stage. All patients are examined for loss
of sensation
(neuropathy)
and also for high pressure points under the foot.
Footscan
showing high pressure points under the feet
|
|
|
| PRESSURE MEASURING DEVICES |
Detection of
high pressure areas under the feet is done by careful examination of the
feet where callus and later foot ulcers usually develop. A prospective
study has demonstrated that high plantar foot pressure is a major factor
in neuropathic foot ulceration. A new computerised machine " FOOT SCAN"
is now available at our centre.
This device is used to check the inshoe pressure precisely and this service is only available at our centre in India. By this device we can examine the pressure
points for potential diabetic foot ulcer very accurately. |
| FOOT
WEAR - New footwear for diabetic patients |
| New types of
foot wear are now being prepared at M.V.Hospital, Royapuram with technical
assistance from Central Leather Research Institute (CLRI) Chennai for diabetic
patients with foot complications. We also provide special foot wear which
is made up of new types of insole materials for patients with high risk
foot. Lightweight, inexpensive and aesthetically appealing, these footwear
will be extremely beneficial to diabetes who require specialised footwear
to prevent pressure points on the feet from developing into calluses and
ulcers that could get infected.
All the patients
with foot complications are educated by the foot care educator regarding
- 1. General Principles of foot care, like nail cutting , cleanliness of
the foot, fungal infection between the toes and the heel fissures. 2. Knowledge
about the right type of footwear and also the importance of wearing the
foot wear . Patients are also provided with books and pamphlets.
 |
 |
| Special footwear prepared at the centre |
|
|
|
|
| Pedicure |
| Pedicure demonstration
is also done for patients with dry skin foot and heel fissures & tips
regarding nail cutting and so on.
|
| Foot
Care Education |
| All the patients
with foot complications are educated by the Foot Care Educator regarding:
(a) General
principles of Foot Care like nail cutting, cleanliness of the foot, fungal
infection between the toes and the heel fissures.
(b) Knowledge
about the right type of footwear and also the importance of wearing the
footwear. Patients are also provided with
books and pamphlets.
|
|
|
| Surgery |
| A dedicated
team of general & vascular surgeons provides surgical care for patients
requiring operative care of their diabetic foot infection. Patients referred
to our hospital are given prompt surgical care & measures are taken
to ensure limb salvage to the extent possible.
|
| Colour
Doppler |
| Colour Doppler
(Duplex) scan to study the extent and severity of PVD and to aid the vascular
surgeon to decide about management.
|
|
|
| Nerve
Conduction Studies |
| Slowing of
Nerve Conduction Velocity is one of the earliest neuropathic abnormalities
in Diabetes Mellitus. Early diagnosis of Diabetic Peripheral Neuropathy
is necessary to prevent fissure formation, infection and ulceration of
the feet. In recent years, a number of Electro physiological testing methods
have been developed for early detection and diagnosis of Diabetic Neuropathies.
These tests quantify nerve conduction and help to localize the lesions.
These studies are carried out by the Electrophysiology Department .
|
| Neuropathic
Detection |
| The development
of neuropathy: Uncontrolled diabetes, over several years, results in damage
to the nerves in the feet leading to a total loss of sensation (neuropathy)
which places patients at a high risk of injuries, trivial or major, which
often go unnoticed. |
| Conclusion |
| The quality
of foot care needs much improvement . The poor knowledge of foot care among
the diabetic patients, lack of proper foot care teams , delayed referral
of patients with foot infections to specialists are some of the factors
responsible for the poor quality of foot care at present. Education of
patients and health care professionals regarding diabetic foot care is
an urgent priority in order to reduce the number of amputations. |
|
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