Foot care services include the examination, diagnosis, and medical or surgical treatment of conditions and dysfunctions of the foot.
Routine Foot Care may include the following:
- The cutting or removal of corns, calluses or plantar keratosis,
- The trimming of nails, (including mycotic nails),
- Other hygienic and preventive/maintenance care in the realm of self-care, such as cleaning and soaking the feet and the use of skin creams to maintain skin tone of both ambulatory and bedfast patients, AND/OR
- Any services performed in the absence of localized illness, injury or symptoms involving the foot.
The following are increased risk factors for ulcers or amputations:
- Diabetes mellitus,
- Vision impairment,
- Diabetic nephropathy, (especially patients on dialysis)
- Poor glycemic control,
- Cigarette smoking,
- Peripheral neuropathy with loss of protective sensation,
- Altered biomechanics (in the presence of neuropathy),
- Evidence of increased pressure (erythema, hemorrhage under a callus),
- Foot or bony deformity,
- Peripheral vascular disease (decreased or absent pulses),
- History of ulcers or amputation,
- Severe nail pathology,
- Arteriosclerosis obliterans, AND/OR
- Buerger’s disease.
Symptoms associated with comorbidities may include:
- Ischemic ulcer,
- Intermittent claudication or other ischemic-type pain,
- Non-palpable pedal pulses,
- Decreased hair growth in the leg,
- Nail overgrowth,
- Abnormal skin texture (thinning),
- Abnormal skin color,
- Abnormal skin temperature (i.e., cold feet), AND/OR
- Pigmentation changes.
In most situations, a family member or nursing staff may perform these services. However, in patients with conditions associated with inadequate circulation to the extremities, routine foot services may require the services of a professional (for example, a podiatrist or physician) in order to limit the potential complications of impaired wound healing and infection.
Preventive foot-care practice, such as annual foot examination by multidisciplinary health care providers, can substantially reduce the risk in patients with foot problems caused by underlying disease, foot deformities, and alteration in the normal perfusion to the lower leg and foot.
If an infection, such as onychomycosis, occurs to the nails, conventional medical treatment requires pharmacological therapy, mechanical intervention or surgical treatment.
Foot ulcers and amputations are a major cause of morbidity, disability, as well as emotional and physical costs for patients with high-risk foot related conditions. Early recognition and management of independent risk factors can prevent or delay the onset of adverse outcomes.