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This article appeared in The Home News Tribune’s 50+ section.
August 2006
Prevent Serious Wounds by Taking Care of Your Feet
By Dr. Marshall R. Feldman
Walking barefoot is a pleasure of summer, but that simple pleasure can be risky for someone with diabetes, poor circulation or neuropathy, a condition in which the nerves lose the ability to feel heat or pain.
Walking barefoot can cause minor cuts, abrasions and burns to the feet. While for many people, that’s a minor discomfort, but for someone with diabetes or poor circulation, those minor cuts and bruises don’t heal as quickly. Someone with neuropathy may not be able to feel a cut. These can then progress to more serious complications, such as a nonhealing wound. Each year more than 80,000 amputations in diabetics are the result of foot ulcers or chronic wounds. If you have diabetes, vascular problems or neuropathy, you need to protect your feet from cuts, burns and scratches.
Avoid open toed shoes or sandals. Your feet need to breathe, so try to avoid sandals and shoes made of manmade materials like rubber and plastic. There are number of sneaker brands that come in widths, so you can be assured of a good fit with enough room at the toes.
Here are a few foot care tips I give my patients to keep their feet injury-free.
- Examine your feet daily in good light. If your vision is poor, have a family member or friend help. You are looking for areas of dryness and cracking, especially around the toenails, between the toes and on the soles.
- Wash your feet in warm, soapy water each day and dry them thoroughly. Use creams and emollients to keep your skin hydrated. You can use creams between the toes, but be sure the area is clean and dry.
- Avoid exposing feet to extreme heat, such as hot sand or pavement. Use sunscreen to prevent sunburn.
- Have a podiatrist treat your corns or calluses. Don’t use commercial corn or callus products because they contain salicylic acid, which can burn. If you have an ingrown toenail, have a professional remove it. If you do get a cut or scrape, treat it and monitor it. If does not seem to be healing, see a doctor.
- While it’s okay to paint your toenails, it’s better to avoid salon pedicures because of the skin shaving and abrasion. Trim toenails straight across and gently round corners with an emery board or pumice stone.
- Wear comfortable, well-fitting shoes. Avoid open toes or heels, and shoes that squeeze the toes together. You want a shoe with a high toe box so your toes are protected and have plenty of room. Medicare has a program to help diabetics pay for Medicare-approved shoes and insoles. Speak to your foot care specialist.
- Wear seamless socks or stockings with shoes. Socks should be clean and changed daily. Avoid elastics to hold up stockings or any undergarment that is tight around the legs.
- Buy new shoes late in the day when feet are slightly enlarged to assure they will fit comfortably at any time. New shoes should never be worn more than two hours at a time.
- Walking is the best exercise for the feet. After exercising, be sure to check your feet for signs or irritation or blisters.
- Prop feet up when seated to increase circulation. Wiggle your toes and move your ankles up and down several times a day.
Marshall R. Feldman, DPM, is a podiatrist with The Wound Care Center at Robert Wood Johnson University Hospital Rahway. The Wound Care Center can be reached at 732-453-2915.
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