Foot Care
F1. Limb Salvage and the Charcot Foot: What the Evidence Shows
Pupp G, Koivunen R. Podiatry Today. 2011;24(3):68-72.
Article Type: Integrative Review
Description/Results:
* Comprehensive overview of Charcot deformity.
* The modified Eichenholz Classification System is presented with addition of stage 0 (warmth, swelling, dull pain, and joint instability).
* Surgical reconstruction may be indicated, but only at institutions with a supportive team effort.
What does this mean for me and my practice?
Appropriate education, referral, and intervention are essential for people with diabetes to prevent a Charcot deformity that could lead to amputation. This article would be helpful for any nurse working with people with diabetes.
F2. Diabetic Neuropathy Status and the Concerns in the Underserved Rural Communities: Challenges and Opportunities for Diabetes Educators
Wang W, Balamurugan A, Biddle J, Rollins KM. Diabetes Educator. 2011;37(4):536-548.
Article Type: Research Study
Description/Results:
* In a cross-sectional study involving 816 participants, 9.6% had diabetic peripheral neuropathy (DPN), 43% reported peripheral neuropathy symptoms (PNS), and 79% of the participants with PNS had not been diagnosed with DPN.
* Delayed diagnosis of DPN may put patients at risk for neuropathic foot complications to include calluses, ulcers, deformities, and amputations.
* The article addresses risk factors for DPN and barriers to early diagnosis.
What does this mean for me and my practice?
Appropriate communication, education, and referral for timely intervention are essential for people with diabetes to prevent a neuropathic foot ulcer that may lead to an amputation.
F3. Evidence-Based Medicine (EBM) and Orthotic Therapy
Huppin L. Podiatry Management. 2011;86(11):97-102.
Article Type: Integrative Review
Descriptive/Results:
* Orthotics have been shown to be effective in reducing foot pain and treating pathologies such as plantar fasciitis, metatarsalgia, hallux limitus, adult acquired flat foot, rheumatoid arthritis, tarsal tunnel syndrome, and lateral ankle instability.
* Provides an overview of orthotics terminology and guidelines for writing orthotic prescriptions.
* Emphasizes importance of patient education in assuring positive long-term outcomes.
What does this mean for me and my practice?
Foot and nail care nursing requires collaborative practice among many disciplines including podiatry, pedorthist, orthotist, primary care, registered dietician, wound care center, and social services.
F4. Beneficial Effects of Foot Care Nursing for People With Diabetes Mellitus: An Uncontrolled Before and After Intervention Study
Fujiwara Y, Kishida K, Terao M, Tahahara M, Matushisa M, Funahashi T, Shimomura I, Shimizu Y. Journal of Advanced Nursing. 2011;67(9):1952-1962.
Article Type: Research Study
Descriptive/Results:
* Prevalence of diabetes is increasing globally, with a concomitant increase in related complications such as diabetic foot ulcers and amputation.
* Presents the impact of a preventive foot care program that includes callus removal and foot care education: reduced incidence/severity of tinea pedis and callus formation, no recurrence of callus-related ulcers, and closure of minor injuries.
What does this mean for me and my practice?
Results suggest that preventive foot and nail care can prevent complications associated with diabetes.
F5. The Role of Certified Foot and Nail Care Nurses in Prevention of Lower Extremity Amputation
Etnnyre A, Zarate-Abbott P, Roehrick L, Farmer S. Journal of Wound, Ostomy and Continence Nursing. 2011;38(3):1-10.
Article Type: Integrative Review
Descriptive/Results:
* Provides current data regarding increasing numbers of individuals who are unable to provide their own nail care or who are at increased risk for lower extremity arterial disease and amputation.
* Presents value of nurses certified in foot and nail care in prevention of lower extremity amputation; addresses need for research to objectively demonstrate impact of preventive programs.
What does this mean for me and my practice?
Valuable article for any foot and nail care nurse; addresses goals and specifics of foot and nail care nursing (routine surveillance, patient education, and early intervention/referrals).
F6. Hemoglobin A1c Predicts Healing Rate in Diabetic Wounds
Christman AL, Selvin E, Margolis DJ, Lazarus GS, Garza LA. The Journal of Investigative Dermatology 2011;131:2121-2127.
Article Type: Research Study
Descriptive/Results:
* Retrospective cohort study of 183 patients to review 19 variables in relation to closure rates for neuropathic ulcers.
* Hemoglobin A1c was the only variable that directly correlated with foot wound healing rates; among patients with lower extremity arterial disease, the impact of hyperglycemia was even greater.
* Addresses mechanisms by which hyperglycemia interferes with healing.
What does this mean for me and my practice?
Provides additional insight regarding the impact of chronic hyperglycemia on wound repair; valuable for any wound care clinician caring for patients with diabetes.
F7. Rheumatoid Arthritis: A Practical Guide for the Primary Care Provider (CME)
Fishcer A, Swigris RE, Lampner C, Beuther D. http://www.medscape.org/viewarticle/745566 2011
Article Type: Integrative Review
Description/Results:
* Provides a comprehensive review of pathology, clinical presentation, and management of RA, with implications for foot assessment, provision of painless foot care, and patient education to reduce symptomatology and complications.
* Addresses multidisciplinary approach and use of complementary/alternative therapies (acupuncture, herbals, massage, tai chi, stones, and supplements).
What does this mean for me and my practice?
Provides essential knowledge for foot care nurses caring for patients with RA.
F8. Fear of Injury With Physical Activity Is Greater in Adults With Diabetes Than in Adults Without Diabetes
Huebschmann AG, Crane LA, Belansky ES, Scarbro S, Marshall JA, Regensteiner JG. Diabetes Care. 2011;34(8):1717-1722.
Article Type: Integrative Review
Description/Results:
* Reviews importance of physical activity for people with diabetes and addresses barriers to routine exercise among people with diabetes.
* Compares barriers to exercise among people with and without diabetes and implications for counseling and education.
What does this mean for me and my practice?
Provides valuable data and guidelines for counseling patients with diabetes about the importance of routine exercise and specific guidelines for implementing exercise programs.
F9. Health-Related Quality of Life in Patients With Nail Disorders
Reich A, Szepietowski JC. American Journal of Clinical Dermatology. 2011;12(5):313-320.
Article Type: Integrative Review
Description/Results:
* Review of studies that focused on quality of life using 1 of 10 different research instruments addressing nail disorders specifically psoriasis, onychomycosis, nail conditions secondary to antineoplastics, and brittle nail syndrome.
* Toenail and finger nail disorders are an important part of the body, and outcomes indicated that nail diseases are a medical concern and should raise attention and receive proper care from providers.
What does this mean for me and my practice?
Authors conclude nails are an important part of overall physical and emotional health and valuable information about the quality of life with condition(s) of the nails. Nails are often neglected so this article reinforces the fact that nail care is important and needs to be addressed.
F10. Footwear Characteristics and Factors Influencing Footwear Choice in Patients With Gout
Rome K, Frecklington M, McNair P, Gow P, Dalbeth N. Arthritis Care & Research. 2011;63(11):1599-1604.
Article Type: Research Study
Description/Results:
* This observational cross-sectional study investigated footwear characteristics and key factors influencing footwear choice in patients with gout, as well as to evaluate the relationship characteristics and foot disability.
* Conclusions supported the fact that people with gout often have poor foot wear and comfort, fit, and support, and costs were perceived to be important factors in choosing footwear.
What does this mean for me and my practice?
Findings suggest that footwear needs to be addressed by the foot and nail care nurse, specifically cushioning, wear and tear, adequate motion control, and mid-foot width.