Guideline Diabetic Foot 2012

8/12/2019 Guideline Diabetic Foot 2012

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2555 31,250


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3

/

2555


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7

7

1 82 monofilament 11

13

3 17

1 20

2 22


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7

(neuropathy) (ischemia) / (infection) (World HealthOrganisation, 1995)

(International Diabetes Federation) 25 (1)

85% (2) 1

(2-5) 1


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8

1

1.

2.

1.1

2.1 (vascularproblems)

1.2

1.3

1.4

1.5

, , , ,

(intermittent claudication) Dorsalis Pedis

Posterior Tibial pulses

, / (amputation), ,,

, ,

, , (peripheral arterial disease)

, , ,

,


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9

2.2 (neurologicalproblems)

2.3 (foot deformity)

2.4 (active foot ulcers)

: (claw toes),excessive high arch, prominent metatarsalheads, ,

callus : protective sensation Semmes-Weinstein Monofilament 5.07 (10 ) 4 2: , ,

dorsal veins, (bounding pulses)

Charcot foot,(pes cavus), (claw toes)

(callus)

(infective ulcer)

ankle-brachial index (ABI)


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10

2.5 (footwear)

(Neuropathic

ulcer)

(Ischemic ulcer)


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11

2 monofilament(4)

monofilament (forearm) monofilament 1-1.5

monofilament 4 ( 1) monofilament 1-1.5 (2)

monofilament monofilament monofilament 3 (real application monofilament ) 2 (sham application monofilament monofilament ?) 1

1)

2)

3)

4)5)


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12

1 2

monofilament monofilament

2 3 ( 1 5) 1 3 (

1 5) 5 1 3

4 2 2 protective sensation (insensate foot) 1

6)

7)

8)

9)

10)

11)


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13

(4-6)(1)

(3-5) 2 1

1.1 (callus)

10 12 3, 4 (normal saline)

(callus)1)

2)

3)


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1.2 1) (inspection)

2) (washing)

15-20

3) (lotioning)

4) (nails care)

5) (corns and calluses) Neuropathy


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15

6) (socks) (impact force)

(sheering force) 7) (proper footwear)

-

- - -

1.3

1.4 1.5 1.6


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2

/ (limb ischemia) ( 2)

2.1 2.2 (eradication of infection)2.3 (ischemia)

revascularization 2.4 (ulcer management)(9)- - - (off-loading)- (exudates) (3)


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17

3

Granulation, no exudate

Granulation with exudate

Necrotic, no exudate

Necrotic with exudate

protect wound bed maintain moist wound absorb exudate control moist wound protect surrounding skin

sharp debridement maintain moist remove infection sharp debridement control moist protect surrounding skin

gauze with NSSHydrogel , Tegadermgauze with NSSHydrocolloid

Gauze with NSSHydrogel , HydrocolloidGauze with NSSHydrogel , Hydrocolloid


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2.5

2.6 Care After Cure

50 2-5

- (self or daily foot care)

- (proper footwear)

- foot care

-

2.7


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1

-:

/

/

-:

-

:

monofilament

4

-

:claudication

ABI

/

ABI>

0.9

/

/

/

ABI

Documents

Guideline Diabetic Foot 2012