- It is necessary to wash the feet daily using a mitt, or soft sponge, or by hand, with warm water and a neutral soap, keeping bathing short so as not to cause any soaking of the skin. After washing the feet, it is important to dry them by contact, avoiding friction as much as possible, while paying particular attention to the areas between the toes. If the foot is not fully dried, this may encourage the growth of pathogenic micro-organisms.
- Diabetic patients should inspect their feet every day and look for bites or punctures, bruises, pressure points, redness, areas of heat, blisters, ulcers, scratches, cuts or problems with the nails. Check the six main points on the sole of each foot: the tip of the big toe, the base of the smaller toes, the base of the middle toes, the heel, the outer edge of the foot, and the transverse forefoot, the most bulky support area on the sole of the foot, which connects to the base of the toes.
- Apply a moisturiser to the heel, sole and back of both feet daily to prevent dryness. It is advisable to use 15% urea creams, while remembering that you should not hydrate the spaces between the toes or do massages using alcohol or cologne.
- As for the nails, they perform a protective function, and they should thus protrude 1 or 2 mm beyond the toe, and the nail cut should be straight and not curved, as on the fingers. Nails should be cut with round-tipped scissors or filed with a cardboard file. A metal file should never be used.
- Callus treatments or pumice stones should not be used, nor should calluses or other foot injuries be handled.
- Avoid walking barefoot on any surface or floor; the foot must always be well protected, in order to prevent unnecessary injuries.
- Synthetic socks with thick seams should never be used, nor garters or girdles that compress and impair circulation. Socks made from natural fibres (cotton, yarn or wool) are recommended.
- Every day you should check the inside of the footwear with your hand for anything that, however small, could have gone unnoticed and potentially caused an injury or chafing.
- Do not use electric pads, hot water bottles or any other heat source to warm your feet, as you may unintentionally burn them, as a result of their impaired sensitivity.
- Do not let your feet get cold, or get wet in snow or rain. It is advisable to wear warm socks and footwear in winter.
- Do not smoke, since smoking damages blood vessels and reduces the body’s ability to carry oxygen, and in combination with diabetes, significantly increases the risk of amputation.
- It is advisable to exercise daily in the form of walks on flat terrain at a good pace for at least an hour.
- If a wound or fissure appears on the foot, apply antiseptics such as chlorhexidine and/or povidone iodine, diluted in saline solution and cover with a sterile gauze dressing. If the injury does not begin to heal in a week, or if it is irritating or weeping, seek a consultation in your Health Centre.
SOURCE: Spanish Association of Vascular and Wound Nursing. Clinical practical guide.
Consensus on vascular ulcers and diabetic foot. 2nd Ed. Seville AEEVH, 2014
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