Page 18 - 10th Annual International Charles Town Maroon Conference and Festival Magazine

June 2018 Charles Town Maroon International Conference Magazine

Foot Care prevents amputations!!!

Diabetes is now at pandemic level around the world. not only the expert intervention of orthopedic
In the US 1.4 million adults are diagnosed with having appliances and antimicrobial drugs but also costly
diabetes each year (American Diabetes Association topical dressings and inpatient care. This leads to
(2014) substantial economic burden that is less than the cost
of amputating.
In Jamaica, the Ministry of Health reported that the
prevalence of both Hypertension and Diabetes have What’s the cost for the healing of a single ulcer? It
increased over eight years (2000-2008), diabetes by goes on… where an amputation is required, look at the
9.7%. It also states that Jamaica is also facing a demo- direct cost of surgery, medication, laboratory,
graphic transition with an increasing ageing popu- debridement, bone resection, cast, shoes, and all others
lation, where there is an increase in relating to inpatient care. When you look at the cost
non-communicable diseases (NCDs), that is diseases related to loss of productivity, preventive efforts, reha-
that are not transmitted from one person to another, bilitation and home care…. Wow! When you look at
amongst this population. Diabetes is one of those – it 7-20% of total expenditure on diabetes care might
along with heart disease, hypertension and cancers. be attributable to diabetic foot ulcer.
Currently, 13.6% of the adult Jamaican population
suffer from diabetes. Foot care in its entirety as a preventative strategy is
recommended. It includes education of the patient and
family, daily inspection of the feet, identification of
Foot complications are among the most high risk patients, referrals to whom, when and where,
serious and costly complication of Diabetes prompt treatment of non-ulcerative lesions and a
multidisciplinary approach to treating established foot
More than half of all non-traumatic lower-extremity ulcers.
amputations occur in people living with diabetes.
When we look at the prevalence of amputations of Footwear plays an important part also and as a
toes, feet and legs - approximately 85% of these are consensus shoe protection should be encouraged. Such
preceded by a non-healing ulcer that has not been things as friction and attrition prevention, reduction of
properly treated. Why go that route when daily foot pressure, stability, easy adjustment, light weight,
examination and self- management can prevent the orthotic friendly and impact absorption are all
need for amputations? necessary when selecting good footwear.

Several factors are involved in the development of foot Pre-existing conditions such as deformities e.g.
ulcers like neuropathy, peripheral vascular disease hammertoes, bunions etc. result in bony prominence
(PVD), limited joint mobility and repeated trauma that gives rise to corns and callouses as a result of
from abnormal load distribution on the foot. The pressure applied by footwear. All of these result in the
underlying causes are usually irreversible and chron- formation of ulcers.
ically progressive. Moreover treatment itself can be
challenging and needs to be long lasting. It requires

17