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Identification of High Risk Foot, History Taking and Clinical Examination

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Dr Ashish S Dengra, Jabalpur    27 November 2018

  1. High risk foot is defined as a foot with progressive deformity, ulceration, infection and/or amputation as a result of diabetes or any other medical condition.
  2. Look for any skin changes, redness, swelling, deformities, loss of hair in the feet. Palpate patient’s peripheral pulses and check ankle brachial index to rule out peripheral vascular disease.
  3. To rule out peripheral neuropathy, 10 g monofilament test, tuning fork test, ankle reflex and VPT test should be performed.
  4. The first step in ulcer prevention is the careful screening for foot problems and detection of patients at high risk. Grading of foot ulcers is important for proper management of foot ulcers.
  5. The University of Texas system: It classifies diabetic foot ulcers into 4 grades (0-4) according to their depth, and then stages every grade of them according to the presence or absence of infection and ischemia (A-D).
  6. Multidisciplinary team approach is required to effectively manage the different aspects of diabetic foot syndrome.

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