Key Steps for Preventing Amputations

More than 25% of American seniors have diabetes, and 10% to 15% of people with diabetes have leg and or foot ulcers. Simple things like managing your diabetes and performing daily foot care can help prevent ulcers, which can be difficult to treat and may eventually require amputation. More than 80% of amputations begin with foot ulcers, so regimented care and prevention are essential.

Every year, more than 70,000 people with diabetes have a lower extremity amputation.  Amputation rates are two to four times greater in the black population than in the white population. Evidence shows that most amputations in patients with diabetes or peripheral arterial disease can indeed be prevented!

 

Tips for prevention of ulcers and diabetic foot amputations

  • Inspect your feet daily
  • Wash your feet daily
  • Do not pick at or remove calluses, corns, bunions, or warts yourself
  • Trim your toenails carefully
  • Do not go barefoot, even around your home
  • Wear clean dry socks
  • Do not smoke
  • Buy shoes that fit properly
  • Schedule monthly foot checkups with your primary doctor or podiatrist

 

Every individual who has lost protective sensation must regularly and properly examine their feet on a daily basis. This is the single-most effective way to protect feet in the absence of the pain warning system.  

 

Footwear selection: A person with normal sensation in their feet can wear almost any shoe style with little risk of injury. However, if the patient has lost protective sensation, poorly designed or improperly fitting shoes can seriously complicate the condition of the feet. Once the patient has lost protective sensation, they should never wear narrow-toed shoes or boots, heeled shoes, shoes with vinyl tops, thongs, or any shoe that is too loose or too tight. Ideally, this person should ideally receive special assistance in selecting the appropriate style and fit of shoes. The shoes should fit the shape of the foot, and there should be at least a half-inch between the longest toe and the end of the shoe.  

In addition to causing loss of protective sensation, neuropathy can also affect the autonomic nerves in the foot, which can lead to dry, cracked skin and an increased probability of foot injuries and wounds. Therefore, proper moisturizer and emollient application is of supreme importance in the prevention of ulcers.

 

This column is sponsored by KSC Cardiology, and the opinions expressed herein may not reflect those of  CFHN or its advertisers.

Bio: Dr. Aparajita is a fellowship-trained vascular and endovascular surgeon. She is the co-author of 20-plus journal articles and publications and was recently nominated for an Inspiration Award by the American Medical Association.