The Foot at Risk: Identification and Prevention of Skin Breakdown

Abstract

This article presents the major predisposing factors and measures associated with preventing nosocomial foot lesions. The combination of nursing interventions and the appropriate use of protective devices can markedly reduce the incidence of foot lesions acquired in the hospital. Patient and family education is another important aspect in preventing skin breakdown of the foot at risk.

Causas referidas para o desenvolvimento de úlceras em pés de pessoas com diabetes mellitus

“…The slowness of the healing process predisposes to infectious complications. In a review in the United States, it is reported that the presence of an ulcer for more than one month without healing can evolve to an infection or ischemia, or even both (29) .…”

The Rehabilitation Nurse in the Home Care Setting: Treating Chronic Wounds as a Disability

“…During a thorough nursing assessment, the rehabilitation nurse will identify other risk factors associated with the development of chronic wounds. Extreme changes in weight (Friebel, 1993), altered nutritional status (AHCPR, 1992;Basta, 1994;Hanson et al, 1993;Schultz, 1993) and dehydration (Basta, 1994), circulatory impairment (Friebel, 1993;Yetzer & Sullivan, 1992), sedating medications (Yetzer & Sullivan, 1992), infection, diabetes mellitus, age, depression (Dittmar, 1989), poor hygiene, drug or alcohol use, smoking (Basta, 1994;Hanson et al, 1993), and very dry (Hanson et al, 1993) or very moist skin are some of the predisposing factors for wound development.…”

“…As a core member of the interdisciplinary team, the rehabilitation nurse collaborates with the physical therapist and the occupational therapist (Neal, 1995b) in choosing the appropriate durable medical equipment, such as wheelchair cushions and bed mattresses (Dittmar, 1989;Friebel, 1993;Jester & Weaver, 1990;Yetzer & Sullivan, 1992). An overhead trapeze, if the client has the strength to use it, can be very helpful for preventing shearing.…”

“…The rehabilitation nurse can implement passive and active exercises prescribed by therapists for the maintenance and improvement of muscle tone and strength (Yetzer & Sullivan, 1992). Patients with heel and foot wounds may be cautioned not to ambulate in order to promote wound healing.…”

"Perfil dos pacientes com diabetes mellitus que possuem úlcera no pé, atendidos em unidade ambulatorial da cidade de Marília-SP"

“…Yetzer et al (1992) referem que as áreas dos pés com tendência para lesões são o hálux, a superfície plantar na região dos metatarsos, as laterais externas do pé, os calcâneos e os maléolos, confirmando assim algumas áreas em nosso estudo.…”