1. Kevin Woo PhD, RN, FAPWCA Module #5
Foot Ulcers in Persons with Diabetes Mellitus (a.k.a. Diabetic Foot Ulcers)
Kevin Woo
PhD, RN, FAPWCA
Module #5

2. Objectives Recognize the significance of diabetic foot ulcers
Describe risk factors for diabetic foot ulcers
Understand the key elements of a lower-leg and foot assessment
Integrate patient education to prevent diabetic foot complications.

6. What is neuropathy
Nerve can be damaged by high levels of glucose in the blood
Neuropathy is evident by sensory, autonomic and motor changes.
Lack sweating
Lack protective sensation
Foot deformity
© Kevin Y. Woo Used with permission

11. Patient education
Educate to empower your patients to take charge and manage their disease and prevent foot complications.

12. Patient Education Discuss the importance of:
Regular blood glucose monitoring.
Checking long-term glucose control (hemoglobin A1c) every 3 months.
Checking feet every day for open wounds, scale and callus (a mirror on the floor to check the bottom of the feet may be helpful).
Not smoking.

13. Patient Education Discuss the importance of:
Wearing proper-fitting deep-toed shoes with orthotics.
Wearing shoes all the time with each step, inside and outside the home.
Not walking barefoot or in socks or slippers that have no support or do not protect feet against sharp objects.

15. - Prevention - Chronic disease management Health promotion
Key Nursing Concepts
- Prevention
- Chronic disease management
Health promotion

16. Key Nursing Diagnoses - Alteration in Skin Integrity
- Impaired Skin Integrity
- Impaired Comfort
- Risk for ineffective peripheral tissue perfusion
- Risk prone health behavior

17. Key Nursing Practice Issues
Assessment for foot and lower leg changes due to diabetes mellitus should start immediately following diagnosis and be ongoing.
Risk factors and co-morbidities can change with patient status.
All disciplines should cooperate to assess patients holistically for glucose control, neuropathy and circulation problems.

18. Websites for Further Information on Types of Wounds
- Association for the Advancement of Wound Care
- Canadian Association for Wound Care
- National Pressure Ulcer Advisory Panel
- World Union of Wound Healing Societies
- Wound Ostomy Continence Nurses Society