FOOT CARE GUIDELINES

Curative Health Services, Inc., a wound care specialty company, has produced an informative pamphlet about caring for your feet. If you are facing diabetogenic circulatory damage ("progressive venous insufficiency"), or dealing with wounds or infections on your feet, the following is good advice! As diabetes is the leading cause of nontraumatic foot and leg amputations, this is especially valid for us. Prevention of complications is always a good start.

Guidelines for Patients With Venous Insufficiency or Wounds (c 1997 Curative Health Services, Inc.)

Give Your Legs a Rest

Elevate your feet above your heart while sleeping and at regular times during the day (elevate foot of bed or mattress). Avoid work that requires you to stand or sit with your feet on the ground for long periods. Change positions frequently. Take walks to help leg muscles "pump" fluid out of your legs.

Give Your Legs Support

Wear professionally made support stockings that apply pressure from ankle to knee or other compression devices (your doctor can help you choose the kind that is right for you and send you to a professional who will properly measure your legs for stocking size). Have at least two pairs of support stockings available so you can change them daily. After laundering, hang them up to dry. Do not put them in a dryer. Always put on support stockings early in the morning before fluid pools in lower legs. Wear support stockings all day and then remove in the evening when going to sleep. Buy new stockings every 6 months so their strength doesn't wear out.

Avoid ACE bandages. It is extremely difficult to wrap them properly to provide the pressure you need.

If your doctor has prescribed the use of a compression pump, follow the instructions completely. It may take a little time to adjust to the pumping procedure.

Take Care of Your Skin

Make sure to wash your lower legs and feet regularly with mild soap and water. This will help to avoid a build-up of lotion. Do not soak your feet. Use moisturizing creams and emollients after washing. It is important not to use petroleum or lanolin based creams when wearing stockings which contain latex. Your doctor or pharmacist may suggest appropriate brands.

Be particularly careful to avoid activities that are likely to cause injury to legs or feet. Prevention is very important.

Watch for Skin Changes

Pay particular attention to signs of progressive venous insufficiency:

* SWELLING that does not go away quickly when you lie down.

* DISCOLORATION, especially brownish skin discoloration around ankles and lower legs.

* DRYNESS AND/OR ITCHING in the same areas.

* ANY WOUND OR BRUISE that doesn't go away within a week.

If Your Wound Doesn't Heal in 1 Week...

Don't put off seeing your doctor. Any wound that doesn't heal in a week should be seen by your physician. Remember you are a vital part of your treatment program and it is essential that you faithfully follow all medical directions. Always consult your physician before making any change to your healthcare routine, if you have questions or if your symptoms are becoming worse.

Guidelines:

If you have a wound...

* KEEP IT CLEAN. Keep minor wounds clean and protected with a bandage.

* AVOID strong antiseptics. Many antiseptics such as hydrogen peroxide, povidone-iodine (Betadine) and sodium hypochlorite (Dakin's solution) can damage skin and interfere with healing.

* DON'T stop wearing support stockings during your daily activities. If it is difficult to wear them over the bandage, put on a knee length nylon stocking first and wear the support stocking over it.

* WATCH the wound carefully. You will need to describe any changes to your doctor. Remember that any wound may turn into a chronic wound and early treatment has been shown to be beneficial.

(Pamphlet reprinted with permission. For more information, contact Curative Health Services, Inc., 14 Research Way, Box 9052, East Setauket, NY 11733-9052; telephone: 1-800-991-4325; website: http://www.curative.com)