Diabetic Foot Care

Diabetes and How it can Affect the Foot

Diabetes is a serious complex condition that can affect the entire body, more specifically we cover diabetic foot care and how it can affect you. Diabetes requires daily self-care and if complications develop, diabetes can have a significant impact on quality of life and can reduce life expectancy. Your feet are at risk because diabetes can cause damage to the nerves in your feet, blood circulation, and infection. Having diabetes can increase your risk of foot ulcers and amputations. This damage is more likely if:

  • You have had diabetes for a long time
  • Your blood glucose levels have been too high for an extended period
  • You smoke – smoking causes a reduced blood flow to your feet, wounds heal slowly
  • You are inactive.

If your diabetic foot develops a wound this is known as an ulcer. If a diabetic foot ulcer is left untreated it can lead to an infection known as osteomyelitis inside the body/bone. Early and accurate diagnosis is necessary to ensure effective treatment and to reduce the likelihood of amputation. Improper diabetic foot care can increase the likelihood of amputation and is 15 times more common to occur in people with diabetes.

Diabetic Foot Care & What to Look out for

  • When you have diabetes, you need to take care of your feet every day
  • Daily care can prevent serious complications
  • Check your feet daily for changes or problems
  • Visit a podiatrist annually for a check-up or more frequently if your feet are at high risk

If you see any of the following- get medical treatment that *day*

  • Ulcer
  • Unusual swelling
  • Redness
  • Blisters
  • Ingrown nail
  • Bruising or cuts

If you see any of the following- get medical treatment within 7 days

  • Broken skin between toes
  • Callus
  • Corn
  • Foot shape changes
  • Cracked skin
  • Nail colour changes

Prosthetic Options

If you have had a partial foot amputation you can have a prosthesis custom made to suit your needs. This can also be called a ‘toe filler’ or bootie. The prosthetic device restores the anatomical shape of the foot and can be designed to reduce pressure and restore balance. Speak to your prosthetist about options best suited to you.

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Care for your Skin

How to clean your residual limb

Being a new amputee now requires you to take care of the skin on your residual limb. We have created a simple 3 step process that shows how to best clean your residual limb. A combination of washing the limb with soap and moisturising the limb regularly will not only make it easier to wear your prosthesis, but will also reduce the frequency of rashes, bacterial infections etc., from appearing on your residual limb. For more information about other skin issues, please download the Residual limb care guide at the bottom of the page.

Step 1: Wash with a mild soap (pH = less than 7)

Step 2: Moisturise after wash to prevent dryness. Only apply moisturiser in the evening.

Tip: If you are a new amputee or have high volume fluctuations in your limb, it’s recommended to shower at night. The heat of the shower and your limb hanging down can make it harder to don your prosthesis in the morning when most users experience their highest volume of the day already. Give it a go!

Care for your Prosthesis

Upper Limb (UL) users: Your socket should be cleaned weekly. You should regularly clean the hand and/or cosmetic glove.

Transtibial (BK) users: Your socket should be cleaned weekly.

Transfemoral (AK) Users: Your socket should be cleaned daily.

 

How to clean your socket & components

When cleaning your socket, wipe your socket with a damp cloth and a mild detergent and dry it thoroughly before you put it back on. It is not necessary to use an antiseptic to clean your socket.

Tip: Never use Dettol or other solvents to clean your socket or liner.

 

Wet/Dirty Prosthesis: It’s important to clean the components as well as the socket. Tip your prosthesis upside down to empty any water out of the foot shell. Use a shoe horn to lever off the foot shell. Remove, clean and dry the spectra sock (nylon sock between the foot shell and carbon fibre foot). Rinse out and dry the foot shell. Put the spectra sock back over the carbon fibre foot and use a shoe horn to reattach the foot shell.

 

Cosmetic Cover: If you have a cosmetic cover, it is important to keep this clean as well. A hard cover can generally be cleaned in the same manner as your socket. A soft/foam cover with stockings – you can wash the stockings as you would any hosiery/delicates. Wipe the foam with a slightly damp cloth and allow to dry before redonning the stockings.

Tip: Remember, keeping your prosthesis clean and drying after getting wet is crucial for maintaining longevity of the components and preventing rust or damage.

Stump Socks – How To Care For Them

The two main reasons for wearing stump socks are:

  1. To protect the residual limb from excessive rubbing against the socket.
  2. To allow the prosthesis to fit better as your residual limb changes. You may find that you wear only one sock in the morning, but have to add a second one as the day progresses. In this case, the sock is used to fill the space between your residual limb and the socket.

Socks & Pelite liners

It is important to find the right combination of socks when using a prosthesis with a pelite liner. This combination can change both throughout the day, and over the life of your prosthesis. With a pelite liner, as you reduce in volume, you may find you need to fill the space between your residual limb and the liner, and/or between the liner and the hard socket to snug up the fit. If you have any queries on how to do this, you can ask your prosthetist.

Socks & Silicone liners

Unlike in traditional pelite liners, when using socks with silicone/gel liners, the sock is used outside the liner between the liner and the hard socket which maintains contact of the silicone/gel with your skin.

Pin liners: It is important to ensure the pin is completely through the hole located at the end of your sock so that the fabric doesn’t get caught in the lock body. If this happens, it can cause the lock to stick and you will have trouble doffing your prosthesis.

Seal-in liners: If your prosthesis uses a rubber sealing ring to create a vacuum suspension, talk to your prosthetist to ensure you understand volume management for your liner type. Some do not support the use of socks. If it does, make sure that the sock is neatly tucked under the sealing ring prior to donning your prosthesis.

If you find you have reduced in volume to an extent that you are slipping inside the liner itself, contact your prosthetist as you may need a new liner, or an alternate solution to be found.

 

Cleaning your stump socks

It is very important to keep your stump socks in a clean and hygienic state. It is important that any socks you wear are cleaned daily.

It is important that you look after your socks and make sure you have enough to wash and wear.

Not washing your socks properly can lead to build up of dirt and other nasties, which may cause skin irritations such as redness, rash, itchiness, bumps, pimples, etc.

Tip: Never wear your shrinker sock with your prosthesis. The shrinker is to be worn to provide compression when you are not wearing your prosthesis. Wearing the shrinker with the prosthesis can cause skin irritation and/or breakdown.

DO’s and DON’TS that will help you clean your prosthetic stump socks correctly

Do’s:

  • Do squeeze suds gently through the prosthetic socks and rinse with clear warm water.
  • Do use an approved wool detergent to wash your socks, preferable by hand.
  • Do roll the socks in a towel to blot out the extra water.
  • Do hang socks to dry.

Dont’s: 

  • Do not use hot water as this might cause your socks to shrink.
  • Do not twist and rub wet socks as this may cause the socks to loose their shape.
  • Do not wring the socks out.
  • Do not use a clothes dryer to dry the socks.

Tip: Be careful of wearing too many socks. If you experience blisters, localised swelling and or a purple tinge to the very end of your residual limb, often accompanied by the tissue consistency firming up over time, you may be packing yourself out of your socket. It’s important to maintain contact with the end of your limb and the socket to avoid this hyperplasia. If you are wearing more than two thick socks consistently, it’s a good idea to check in your prosthetist to assess socket fit.

 

Care for your Liner

Liner Care

If you have a prosthetic liner you should wash it on a daily basis. Never put your liner in a washing machine or clothes dryer, as it may damage or even destroy it. Ensure the soap/detergent you use is non-abrasive, mild and no fragrance. These substances and harsh detergents and chemicals can slowly eat away at the silicone or gel and reduce the life of your liner.

 

How to clean your liner

Step 1: Use a damp cloth with a mild detergent to wipe it out

Step 2: Dry it with a towel and leave it overnight to dry completely.

Step 3: Leave liner to dry the right way out (silicone/gel on the inside). This ensures no dust or other particles will stick to the inner surface. Note: Leaving the liner rolled up or inside out can warp the shape and damage the inner surface which can lead to skin abrasions and irritations.

Tip: Quick refresh! During a sweaty day you can do a quick refresh by only cleaning the inside of the liner and drying with a chamois or micro fibre towel. Not getting the fabric outer wet means you can get on with the rest of your day with a fresh liner.

Deep cleaning: You can completely submerge your liner in warm, soapy water to deep clean the outer layer of protective fabric as it is required.

Make sure to remove any grit, skin or fluff from the inside of your liner, as this can cause both skin irritation/rubs or reduce the effectiveness of the suspension of the liner.

It is important to rinse out the liner with clean water (no soap) to remove any soapy residue as this can cause skin irritation/contact dermatitis.

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