Leprosy
Mailing List, April 15th, 2008
Ref.: Multidisciplinary
approach for diabetic and leprosy feet.
From: Faber W.,
Amsterdam, The Netherlands
Dear Salvatore,
Recently, there has been an interesting
discussion on the LML about the management of ulcers on the feet of
leprosy patients. It
has not been clear, however, how big the burden of neuropathic foot
care is in programmes or institutions where people afflicted by
leprosy are treated? I
would be interested to get comments on the following points.
It is of interest, with the new WHO policy of
sustainable leprosy care in mind, to have an estimation of the
prevalence and workload of these patients. And in this respect I think
neuropathic foot ulcers are the most important. Also, ulcers are the entry
point of infection leading to soft tissue infection and
osteomyelitis. As ulcers on deformed feet, with the Charcot
foot as the most extreme presentation, are more difficult to manage
it is of interest to have information on deformity, and localisation
of the ulcers.
For this purpose the Dutch Neuropathic Foot Society has
developed a registration form, the so-called FINU form, which can be
used for all kinds of neuropathic feet. And which is very useful to
register the changes, including ulcers, of the feet, and is also of
value in follow-up.
However, in the (near) future the “diabetic
foot” will be a far bigger problem than the “leprosy foot”. And it is of interest to
know to which extent the knowledge and skills of professionals
involved in the care of leprosy feet are also used for the care of
diabetic feet. And if
they participate in a multidisciplinary approach for diabetic feet.
Best regards,
William
