Foot care / hyperbaric oxygen therapy

Foot lesions and nail lesions are important complications for people with diabetes and hemodialysis. Diabetes, kidney disease, and hemodialysis are vulnerable to infections, so it may be difficult for the infection to subside due to slight scratches or swelling. Dialysis often has vascular lesions, which can lead to amputation in severe cases. The feet are hidden by shoes and socks, but let's protect them from foot lesions by taking care (this is foot care) when you feel uncomfortable. Do you know about foot care that you can do yourself? In our foot care outpatient department, in addition to treatment and medication, we will inform you about the method that suits each person's blood sugar, kidneys, physical condition and feet, such as knowledge about self-foot care.

1. Importance of foot care

2. Foot care procedure

3. Foot care outpatient

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1. 1. Importance of foot care

1. Hyperglycemic conditions with high blood sugar levels in diabetes are nutrients for bacteria and easy to reproduce. In addition, long-term hyperglycemia leads to diabetic neuropathy and arteriosclerosis. In dialysis, arteriosclerosis impairs blood flow, making it colder and harder to heal.

2. Hyperglycemia itself reduces the recent resistance of white blood cells, reducing their resistance and making it harder to protect the body from bacterial infections.

3. Diabetic retinopathy, hypertensive ophthalmopathy in dialysis, cataracts associated with aging, etc. make it difficult to detect changes in the condition of the foot, and diabetic neuropathy and arteriosclerosis of the dialysis cause sensory impairment of the foot. Even if you have a foot lesion, time may pass without feeling any pain. If left untreated, diabetic foot lesions (ulcers and gangrene of the foot) and severe ischemic limbs (impaired blood flow in the foot due to arteriosclerosis that occurs in people with dialysis) may lead to more severe sepsis in some cases.

4. It is necessary to improve the blood sugar level and to take care of your feet so that your feet, which are also called the second heart, can continue to play an active role.

5. Your feet are covered with shoes and socks, but look and touch your feet every day, and take care of your feet when you feel sick to prevent foot lesions. If you have any concerns, please let us know as dialysis patients come to the hospital three times a week for dialysis treatment. Early detection is important.

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2. Foot care procedure ​

1. Look and touch.

2. As with any illness, "early detection and early treatment" is probably the most important. Look at every corner of your foot every day and touch it to find out.

3. If you find a part that is difficult to see, use a mirror or help your family to find out.

4. After a long walk or exercise, you may be sick or scratched. Please check it out.

5. To prevent infection, lather with soap and gently wash with a soft towel or sponge to clean.

6. Athlete's foot is likely to form between the toes. Please take enough water after soap. The trick is to wipe it down.

7. Dialysis patients often have dry skin due to water restrictions. At that time, moisturize the skin with a moisturizing cream. Applying a moisturizer between your toes can make it damp and prone to athlete's foot. Please be careful.

8. When cutting nails, it is said that it is better to leave a little. Please note that deep nails are easy to cause infection.

9. For the corners of the nails, square cut or square off is said to be good for foot care, especially for ingrown nails.

10. Choose shoes that suit your feet. It is said that shoes that have a 1 cm margin on the toes and that match the shape of the foot are good.

11. Choose shoes that are soft on the leather and inside, and have no hard seams inside.

12. Choose shoes that have good cushioning and a stable sole.

13. It is said that athletic shoes with laces and velcro are good so that the ankles are fixed when exercising or taking a walk.

14. If you have diabetic neuropathy or dialysis, check your shoes for stones or foreign objects before putting them on. This is to prevent scratches.

15. Wearing socks will help prevent athlete's foot and protect your feet.

16. Wear a cotton material with good hygroscopicity, soft inner seams, and socks that are not too tight.

17. Toe socks are also said to be good for preventing athlete's foot.

18. People with diabetes and dialysis are vulnerable to low-temperature burns due to blood flow disorders and neuropathy. Be careful of low-temperature burns on hot water bottles and electric hot water bottles.

19. When using, please switch off with a timer, set the temperature to the lowest, wrap it in a towel, and prevent burns.

20. It may be more dangerous for people with diabetes or dialysis to shave their eyes and octopus by themselves and to use over-the-counter medicines. Please contact us at the foot care outpatient department.

21. If you have a scratch, wash it with running water and lathered soap, protect it with clean gauze or tape, and consult with a foot care outpatient.

22. If you have diabetes or dialysis and your foot is red and has a fever, please consult a medical institution immediately.

3. 3. Foot care outpatient

1. We have established a foot care outpatient clinic to prevent diabetic foot lesions such as foot ulcers and foot gangrene and severe ischemic limbs, not limited to people with diabetes and dialysis.

2. In order to prevent your important foot disorders and protect your feet for the rest of your life, the nurses will work together to think about daily care methods that are suitable for each patient, and when you feel comfortable on your own feet. It is an outpatient clinic that will help you to take care of yourself.

3. Please make a reservation by phone during the consultation hours of our hospital. In case of an emergency, we will do our best to accommodate you.

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References

Japan Foot Care and Foot Disease Medical Association, National Center for Global Health and Medicine Hospital Diabetes Foot Care Outpatient Book Diabetes Foot Care Outpatient Note 2014