Leprosy
Mailing List, May 8th, 2008
Ref.: Multidisciplinary
approach for diabetic and leprosy feet
From: Premkumar
R., Karigiri, Tamil Nadu, India
Dear Salvatore,
I would like to reply to Prof. William Faber’s message
dated LML April 15th, 2008.
The answer to his question is, yes; to a very large extent the
knowledge and skills of we professionals involved in the care of
leprosy feet, like surgeons, physio-occupational therapists and
footwear technicians are also used for the care of diabetic feet at
Karigiri; as well we participate in a multidisciplinary approach for
diabetic feet. At Karigiri from where this letter is being sent, each
Wednesday a diabetic clinic is held in which approximately 30 patients
attend. The management is
clinical examination of patients & chemotherapy, diet therapy,
ophthalmology and foot care and it is a basic package to each diabetes
patients.
As far as foot care is concerned, general
examination of the feet for deformities & skin condition, sensory
(biosthesiometry & monofilament) and intrinsic muscles testing,
and vascularity tests are done. The
above findings are used in classifying the foot into low/moderate/high
risk groups. The foot
management is based on these diagnoses. Management normally
consists of patient education, selection of footwear, and treating
pre-ulcerative condition/s i.e., reduction of callus, corns and
fissures.
Last but not least, based mainly on our leprosy
experiences a chapter on the footwear for diabetes was written by us
in the 4th edition of a practical guide to diabetes mellitus; it is in
the press. Editor – Dr.
Nihal Thomas. Publishers
– Academa Publishers, Delhi. Since
I do not have Prof William’s address would you please send my above
reply to him?
Warm greetings,
Premkumar (PhD)
